TITLE:
Etiologic Aspects of Epileptic Seizures of Recent Onset in HIV-AIDS Infected Subjects at the Yaounde Central Hospital (Cameroon)
AUTHORS:
P. C. Mbonda, C. Kuate, A. K. Njamnshi, Y. Fogang, J. Fonsah, W. Muna
KEYWORDS:
Epilepsy; HIV/AIDS Infection; Cerebral Toxoplasmosis—Yaoundé (Cameroon)
JOURNAL NAME:
World Journal of AIDS,
Vol.3 No.2,
June
11,
2013
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.