Background

• Epilepsy is defined as the recurrence of, at least, two epileptic seizures with sudden occurrence of abnormal signs which could be: motor, tonic, sensitive, sensorial, neuro-vegetative, or psycho-behavioural. These symptoms could or could not be associated to a loss of conscience. It can appear at any age.
• Epilepsy is the most common result of brain cells disturbance that lead to excessive nerve-cell discharges. According to the disturbance on some or many groups of cells, seizures could be partial or generalized.
• Seizures with tonic-clonic muscle movements are named convulsion or fit or attack. Convulsion can appear at any age; all convulsions are not systematically epilepsy.
• Epilepsy is frequent in the Region and its prevalence rate range from 2.2 to 58 per 1000 persons. Studies from five sub-Saharan African countries showed an incidence ranging from 64 to 156 per 100,000 person/year.
• This higher incidence may be a consequence of many risk factors which are related with predisposing factors such as poor perinatal care, head trauma, consanguinity.
• Many etiological factors are related with communicable diseases (malaria, tuberculosis, meningitis, neurocysticerocisis and HIV), noncommunicable diseases (high blood pressure, diabetes, alcoholism and illicit drug use), poorer medical facilities, poorer general health and a lower standard of living. Misunderstanding linked to cultural beliefs, sigma and exclusion do not facilitate appropriate care.
• Epilepsy substantially increases mortality risk, particularly in conditions of later detection due to lack of well-trained health workers to diagnose and treat neurological disorders.
• Death and injury occur primarily due to status epilepticus (especially in the case of abrupt medication withdrawal), burns and drowning.

It has been estimated that in developing countries, up to 80% of people with epilepsy are not receiving treatment, or are often not even identified. While the etiological diagnosis of the epilepsies may be more difficult in developing countries, due to limited investigative resources, many can be diagnosed on the basis of simple clinical and epidemiological knowledge.