Risk factors associated with epilepsy in a rural area in Cameroon: A preliminary study

Introduction: An epileptic area with very high endemicity has been described in Bilomo, a village near Yaounde, the capital city of Cameroon. Purpose: This study was carried out to determine some of the risk and precipitating factors associated with epilepsy in Bilomo. Patients and Methods: This was part of a community-based door-to-door survey in 1999, using the survey instrument developed by the Institute of Neurological Epidemiology and Tropical Neurology of Limoges, the Pan-African Association of Neurological Sciences and the International League Against Epilepsy. Neurological evaluation and confirmation of epilepsy was done by consultant neurologists. Results: 93 cases of epilepsy were confirmed in the study population of 1898 subjects, giving a prevalence rate of epilepsy in Bilomo of 4.9%. The main risk factor for epilepsy was a positive family history (63.44%). The neurological examination was abnormal in 22.6% of patients. Mental retardation was found in 17.2%, psychological disorders in 16.1%, a pyramidal syndrome (unilateral or bilateral weakness with spasticity and Babinski sign) in 6.4%, language disorders in 4.3%, and a cerebellar syndrome in 1.1% of the patients. Subcutaneous nodules were observed in 13 patients (14%). Pruriginous dermatoses were found in 23 patients (24.7%). A possible aetiologic factor was found in 66 patients (71%). The other risk factors included prenatal (8.6%) and perinatal (19.4%) factors, central nervous system infections (9.7%) and head injury (5.4%). Conclusion: The data from this preliminary study suggests that in Bilomo village, the risk factors associated with epilepsy include both hereditary and acquired factors and we postulate that there may be a complex interplay of these factors in the aetiogenesis of epilepsy in this area. These results call for more studies in an attempt to determine the aetiologic factors and more importantly, the interplay between these factors that is responsible for making epilepsy endemic in this area. Such information is vital for an effective national epilepsy control programme.