Original Articles Causes of uncontrolled seizures among Sudanese children

Badrelddin A. Abass, Inaam N. Mohamed, Maha A. Elseed, Zein A. Karrar


Introduction and Objectives: An uncontrolled seizure in children is a commonly encountered problem.
The aim of this study is to investigate for the possible causes of uncontrolled seizures among Sudanese
Patients and methods: This is a cross sectional, hospital based study conducted in 2013 at the two main
epilepsy outpatient clinics in Khartoum State. An uncontrolled seizure is defined as a seizure, which is
persistent despite the prescription of one or two first line anticonvulsant drugs and having a frequency of
more than one seizure per month over the last 6 months.
Results: Out of 240 patients with seizures, 65(27%) fulfilled the inclusion criteria, 32(49.2%) were on
two anti-epileptic drugs (AEDs), 18(27.7%) on polytherapy and 15(23.1%) on monotherapy. The majority
of patients were of low socioeconomic status. In 27(41.5%) patients the cost of AEDs accounted for
10-20 % of the monthly family income. The commonest cause of uncontrolled seizures was found to be
unaffordability of AEDs in addition to other causes.
Recommendations: There is a dire need for AEDs to be available at an affordable cost especially for
children on multiple drugs and to be fully covered by health insurance. Some of the AEDs need to be
registered in Sudan.


Original ;Articles ;Causes of; uncontrolled ;seizures among ;Sudanese ;children

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Berg AT, Levy SR, Novotny EJ, Shinnar S.

Predictors of intractable epilepsy in childhood:

A case-control study. Epilepsia 1996; 37: 24-

Sperling MR. The consequences of

uncontrolled epilepsy. CNS Spectr 2004 ; 9:98-

Leonardi M, Ustun TB. The Global Burden of

Epilepsy. Epilepsia 2002; 43:21-5.

Boer HM, Mula M, Sander JW. The global

burden and stigma of epilepsy. Epilepsy Behav

; 12:540–546.

Oskoui M, Webster RI, Zhang X, Shevell MI,

Factors predictive of outcome in childhood

epilepsy. J Child Neurol 2005; 20:898-904.

Meyer AC, Dua T, Ma J, Saxena S, Birbeck

G. Global disparities in the epilepsy treatment

gap: a systematic review. Bull World Health

Organ 2010; 88:260–266.

Meinardi H, Scott RA, Reis R, Sander JW.

ILAE Commission on the Developing World;

The treatment gap in epilepsy: the current

situation and ways forward. Epilepsia. 2001;


Scott RA, Lhatoo SD, Sander JW. The

treatment of epilepsy in developing countries:

where do we go from here? Bull World Health

Organ 2001; 79:344–351.

Mbuba CK, Ngugi AK, Newton CR, Carter

JA. The epilepsy Supporting Information

treatment gap in developing countries: a

systematic review of the magnitude, causes,

and intervention strategies. Epilepsia 2008;


Alexandra Cameron, Amit Bansal, Tarun

Dua, et al. Mapping the availability, price,

and affordability of antiepileptic drugs in 46

countries. Epilepsia 2012; 53:962–969.

Asadi Pooya, Emami M,Ashjazadeh N.

Reasons for uncontrolled seizures in children:

the impact of pseudo intractability. Epilepsy

Behave. 2012; 25:341-4.

Heaney DC, Begley CE, Heaney DC,

Begley CE. Economic evaluation of epilepsy

treatment: a review of the literature. Epilepsia

; 43: 10-16

Mac TL, Le VT, Vu AN, Preux PM,

Ratsimbazafy V. AEDs availability and

professional practices in delivery outlets in

a city centre in southern Vietnam. Epilepsia

; 47:330–334.

Chomba EN, Haworth A,Mbewe E,

AtadzhanovM, et al. The current availability

of antiepileptic drugs in Zambia: implications

for the ILAE/WHO ‘‘out of the shadows’’

campaign. Am J TropMed Hyg 2010; 83:571–

Causes of uncontrolled seizures among Sudanese children

Asadi-Pooya AA. Drug compliance of

children and adolescent with epilepsy.


Al-Faris EA, Abdulghani HM, Mahdi AH,

Salih MA, Al-Kordi AG. Compliance with

appointments and medications in a pediatric

neurology clinic at a University Hospital in

Riyadh, Saudi Arabia. Saudi Med J. 2002; 8:


Inaam.N. Mohamed, Hyder Alhadi.

Traditional and Spiritual medicine in epilepsy.

Sudan J Paediatr 2013; 13:31-37.

Hauser WA, Annegers JF, Kurland LT.

Incidence of epilepsy and unprovoked seizures

in Rochester, Minnesota. Epilepsia 1993;


Frucht MM, Quigg M, Schwaner C, Fountain

NB. Distribution of seizure precipitants

among epilepsy syndromes”. Epilepsia 2000;

: 1534–39.

Ko TS, Holmes GL. EEG and clinical

predictors of medically intractable childhood

epilepsy. Clin Neurophysiol 1999; 110:1245-

Berg AT, Levy SR, Novotny EJ, Shinnar S.

Predictors of intractable epilepsy in childhood:

A case-control study. Epilepsia 1996; 37: 24-

Liu RS, Lemieux L, Bell GS. Progressive

neocortical damage in epilepsy. Ann Neurol

; 53:312-24

Nolan MA, Redoblado MA, Lah S, Sabaz M,

Lawson JA, Cunningham AM. Intelligence

in childhood epilepsy syndromes. Epilepsy

Research 2003; 53:139-50.

Smith DF, Baker GA, Dewey M, Jacoby

A, Chadwick DW. Seizure frequency,

patient-perceived seizure severity and the

psychosocial consequences of intractable

epilepsy. Epilep Res 1991; 9:231-41.

Sperling MR. The consequences of

uncontrolled epilepsy. CNS Spectr. 2004 ;


Setyo Handryastuti, Irawan Mangunatmadja.

Risk factors influencing the outcomes in

infants with epilepsy. Paediatr Indones 2007;


WHO, Health Action International. Measuring

medicine prices, availability, affordability

and price components. 2nd ed. WHO &Health

Action International, Geneva 2008; Available

at: http://www. haiweb.org/medicineprices/



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