Potentiel d’indication chirurgicale de l’épilepsie en milieu neuropsychiatrique a Kinshasa : cas du centre de santé mentale Telema : étude préliminaire

Background and objectives Approximately 30% of epilepsy patients do not respond to medical treatment and are potential candidates for surgical treatment whose indication is based on the electro-clinical and imaging data. The objective of this study was to describe anthropometric and clinical characteristics and evolution under treatment of epileptic patients, documenting the level of investigation of this pathology to identify patients potentially eligible for surgery. Methods We conducted a descriptive documental study covering a period of 2 years. The variables of interest included: anthropometric data, the characteristics of epilepsy, treatment data, the level and results of complementary investigations. Results A total of 1184 new epilepsy cases were included. The median age was 19 years with a sex ratio M / F 1.1. Sixty-eight percent of patients had an age of onset below 20 years and over 90% had generalized tonicclonic seizures. During treatment, seizures freedom was observed in 31% of patients and 22% had persistent or worsening. The EEG was performed in 17% of patients and CT scan was at 0.8%. Twenty percent of patients had received at least two antiepileptic drugs. Approximately 26% of patients followed for 2 years or more were considered refractory. Conclusion Epilepsy affects patients in school age and young adults who are ideal candidates for surgery in cases of drug resistance. However pathology remains less investigated. A broader investigation program will identify particularly lesional epilepsy in order to submit these patients to an evaluation for neurosurgical treatment