Abstract
Introduction: Patients infected with HIV usually develop neurological complications. Seizures are amongst clinical manifestation of these neurological complications of HIV infection. We report on 150 HIV positive patients who presented with newly onset seizures. Objectives: Our objective was to evaluate the influence of HIV infection on epilepsy and particularly to look for the most common epilepsy induced complications in our context. Methodology: We recruited all patients infected with HIV and who consulted at the outpatient or admitted in the in the neurology unit of the Yaounde Central Hospital, for seizures from August 1st 2008 to December 31st 2009. All the patients were aged above 18 years, black and of Cameroonian nationality. All those who had a family history of epilepsy, as well as those with a personal history of epilepsy were excluded from the study. Results: During the period of study, we recruited 150 patients aged 38.7 ± 9.9 years and with an M/F sex ratio of 0.76. Generalized seizures were observed in 66% of patients, of whom 58% were HIV 1 positive and an average CD4 count of 65.4 ± 11.7/μl. Cerebral toxoplasmosis was the most common etiology observed in 30% of cases. Discussion: This study being hospital based must have selected the most serious patient with severe immunodeficiency. This can explain why a precise etiology was found in the majority of cases. Modi et al. (1999) found a space occupying lesion in 53%, meningitis in 22% and 25% without identifiable etiology in black South Africans. Central nervous system tuberculosis was the most frequent cause encountered in 64% of patients with etiologies. Conclusion: Seizures are one of the principal manifestations of HIV infection or its complications. Their prevalence is 9.5% in our study. Cerebral toxoplasmosis is the most frequent etiology in our study, followed by cryptococcal meningitis and tuberculous meningitis.
Highlights
Patients infected with Human Immunodeficiency Virus (HIV) usually develop neurological complications
We recruited all patients infected with HIV and who consulted at the outpatient or admitted in the in the neurology unit of the Yaounde Central Hospital, for seizures from August 1st 2008 to December 31st 2009
Patients infected with HIV usually develop neurological complications like: cerebral toxoplasmosis, tuberculous meningo-enkephalitis, cryptococcal meningitis, cytomegalovirus infection, lymphomas, dementia, myelopathies and polyneuropathies etc
Summary
Patients infected with HIV usually develop neurological complications. Seizures are amongst clinical manifestation of these neurological complications of HIV infection. Discussion: This study being hospital based must have selected the most serious patient with severe immunodeficiency This can explain why a precise etiology was found in the majority of cases. Conclusion: Seizures are one of the principal manifestations of HIV infection or its complications Their prevalence is 9.5% in our study. Ogun [1] in a Nigerian study estimated that 45.5% of patients infected with HIV develop neuronlogical complications and Bhigjee [2] in South Africa estimated a rate of 70%. Patients infected with HIV usually develop neurological complications like: cerebral toxoplasmosis, tuberculous meningo-enkephalitis, cryptococcal meningitis, cytomegalovirus infection, lymphomas, dementia, myelopathies and polyneuropathies etc. Bartholomei et al [7] in France discovered that 33% of patients infected by the HIV present with epileptic crisis as inaugural neurological manifestation
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