Prevalence and potential causes of epilepsy in Nigeria

Abstract

We read with interest the report by Osakwe et al. Osakwe et al., 2013) purporting to have estimated and ompared prevalence rates and potential causes of epilepsy n two distinct settings in Nigeria. While this is commendble given the dearth of epilepsy data from Nigeria, we ave some concerns arising from methodological issues. he definition and categories of epilepsy investigated are ot provided. It is known that the prevalence of lifeime epilepsy differs (and is higher) from that of active pilepsy (Ngugi et al., 2010). It is unclear if the authors ncluded non-convulsive epilepsies or the data presented eflects convulsive epilepsies only. The gold standard for ase ascertainment in epilepsy is clinical history taken by an xperienced epilepsy clinician (ILAE 1993; Thurman et al., 011), but it is not clear how cases in this study were idenified beyond the house hold interviews by field assistants. o information is provided on the interview process if for nstance it was standardized and validated. With these eleents missing, there is uncertainty whether all identified cases’ were actually people with epilepsy. The authors attempted to identify risks factors for pilepsy which they described as potential causes of pilepsy. This exercise seems to have only involved interiewing identified cases rather than including a comparison roup of non-cases (Thurman et al., 2011). While this has een acknowledged as a limitation of the study, in the bsence of an appropriate comparison group, this informaion is of little value as the distribution of the same factors n the general population is unknown.