الفهرس 
EpilepsyOnly 14 pages are availabe for public view
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Abstract
Epilepsy is the fourth most common neurological disorder and affects people
of all ages Epilepsy is a chronic disorder, the hallmark of which is recurrent,
unprovoked seizures. A person is diagnosed with epilepsy if they have two
unprovoked seizures (Sirven et al, 2014).epilepsy is now called a disease,
rather than a disorder. This was a decision of the Executive Committees of
the ILAE and the International Bureau for Epilepsy. Even though epilepsy is
a heterogeneous condition (Robert and Fisher, 2014). Epilepsy accounts for
0.6% of the global burden of disease (WHO, 2019). In 2016, there were 45·9
million patients with all-active epilepsy (both idiopathic and secondary epilepsy
globally; age-standardized prevalence 621·5 per 100000 population; of these
patients, 24·0 million (20·4–27·7) had active idiopathic epilepsy (prevalence
326·7per100000population).
Prevalence of active epilepsy increased with age, with peaks at 5–9 years
(374·8) and at older than 80 years of age (545·1).Age-standardized prevalence
of active idiopathic epilepsy was 329·3 per 100000 population. 470,000
children had active epilepsy during 2015(CDC, 2015).
Meta-analysis is an epidemiological technique for amalgamating, summarizing
and reviewing previous quantitative research, by using meta-analysis. Evidencebased
Practice can be defined as ”the conscientious, explicit and judicious use
of current best evidence in making decisions about the care of clients”.
The aim of the present study is to establish evidence based practices in
prevalence and determinants of epilepsy among school children in Egypt.
Methodology: According to guidelines outlined by the preferred reporting items
for systematic review and meta-analysis (PRISMA) statement, the researcher
made the research in Medline, Eulc, Epic and other databases which were
published between January 1990 to end of december, 2017.The researcher reviewed the theses, papers, journals, in Egyptian studies in
English language, searching for the eligible studies.
The researcher visited the libraries (central and digital) in the medical faculties
and nursing faculties as well, nutritional institute in Cairo, national research
center in Cairo. The visited universities were, Cairo, Ain Shams, Azhar, Banha,
Zagazig, Tanta, Shibin El-Kom, Mansoura, and Alexandria Universities. The
researcher collected data from theses of Msc., MD., PHD which focus on
prevalence, incidence and determinants of epilepsy among epileptic children.
58 studies were found, which focused on epileptic children risk
factors,incidence and prevalence, fulfilled the inclusion criteria and located
within the assigned time of research. Meta-analysis was done using MedCalc
software ver. 12.7.7.0.
Results:
Prevalence rate in the present met-analysis, studies with total number of
692100. Proportion was 4.91/1000.
Idiopathic epilepsy with number of 3134. Proportion was 72 %. Generalized
seizures with total number of3874. Proportion was 59.5 %. Partial type with
total number of 4341. Proportion was 32.8 %. Partial simple type with total
number of 1585. Proportion was 13.3 %.Cases with secondary generalization
with total number of 1896. Proportion was 14.6 %.Unclassified type with total
number of 2006. Proportion was 9.4 %. Atonic type with total number of 329.
Proportion was 12.7 %. Clonic type with total number of 744. Proportion
was 3.7 %. Myoclonic type with total number of 2361. Proportion was 3.8
%. Tonic type with total number of 1418. Proportion was 9.5 %. Tonic clonic
type with total number of 2153. Proportion was 34.3 %.Controlled on AEDs with total number of 1312. Proportion was 54.3 %.
Uncontrolled on AEDs with total number of 1599. Proportion was 44.4
%. Monotherapy with total number of 2909. Proportion was 58%.
Polytherapy in the present met-analysis, 26 studies were analysed with
total number of 2891. Proportion was 31.7 %. Cases stopped treatment
with total number of 288. Proportion was 25.6%.
EEG abnormality with total number of 2606. Proportion was 70.3%.
Cases with postictal manifestation with total number of 430. Proportion
was 72 %. Drowsiness with total number of 207. Proportion was 30 %.
Incontinence with total number of 206. Proportion was 44 %. Headache
with total number of 929. Proportion was 24.6 %. Long sleep with total
number of 686. Proportion was 39.8 %.
Learning disability (LD) The mean LD score was significantly lower in
epileptic children than controls (69.3, 75.9, t = 2.2, P = 0.028).
Body mass index (BMI) The mean BMI was significantly lower in epileptic
children than controls (17.1, 19.4, t = 5.07, P = 0.001).
Weight The mean weight was non-significantly difference in epileptic children
nor controls (t = 0.4, P = 0.64). Consanguinity 42.2% positive cases (212/502)
and 20% (698/3474) controls. Odd ratio=1.55, 95% CI=1.18 to 2.03, Z=3.22,
P=0.001).
Family history with 40.6% (204/502) positive cases and6% (210/3474)
controls. (Odd ratio=2.54, 95% CI=1.56 to 7.77,Z=3.04,P=0.002).
Education illiterate with 32.8% (82/250) positive cases and29% (58/200)
controls . Total random effects (Odd ratio=1.5, 95% CI=0.81 to 2.88, Z=1.339,
P=0.181). Rural residence with 47.2% (293/620) positive cases and 48%(250/520) controls .total random effects (Odd ratio=1.03,95% CI=0.80 to 1.32,
Z=0.239, P=0.811).
As regards some Risk Factors:
Prenatal risk factors with total number of 231. Proportion was 11.5 %.
Perinatal risk factors with total number of 1235. Proportion was 14.7 %.
Natal risk factors with total number of 122. Proportion was 23 %. Post natal
infection with total number of 1875. Proportion was 16.6%. Post natal trauma
with total number of 1958. Proportion was 8.4 %.. Need for incubator with
total number of 823. Proportion was 19.3 %. Febrile convulsions with total
number of 450. Proportion was 25.7 %. Developmental delay with total
number of 143. Proportion was 79.3 %. Mental retardation with total number
of 945. Proportion was 11 %. Behavioral disturbance with total number of
698. Proportion was 30.9 %. Congenital malformation with total number of
503. Proportion was 3.9 %.