Etiological Spectrum of Status Epilepticus in Ouagadougou, Burkina Faso: A Prospective Cross-sectional Multicenter Hospital Study

Abstract

Introduction: In sub-Saharan Africa, cerebrovascular aetiologies of status epilepticus (SE) are on the rise alongside infectious brain lesions. The aim of our study was to describe the etiologic spectrum of SE in Ouagadougou, Burkina Faso, in a high risk SE setting. Patients and methods: This is a prospective, cross-sectional, descriptive, multicenter and hospital study of patients hospitalized consecutively in the university hospitals of the city of Ouagadougou, in Burkina Faso, from 01/01/2015 to 12/31/2019, for SE. The sociodemographic, clinical, paraclinical (biological, critical and / or intercritical EEG, neuroradiological) characteristics and the aetiological data of the patients were analyzed using the Epi-info 7.2.1.0 software: calculations of numbers, frequencies, averages. The significance rate was set at 0.05. Results: 91 patients hospitalized for SE were collected, with a male predominance (73.62%). The mean age was 36.6 years +/24.5 years (2 days and 86 years); 25 patients (27.5%) already had known epilepsy. Generalized tonic-clonic SE from the start and focal SE with convulsive bilateralization were the most common seizure types with 46 cases (50.5%) and 27 cases (29.7%), respectively. The average duration of an EME episode was 18 hours +/31 (5 minutes 6 days). On admission, a focused motor deficit with 36 cases (46.7%) and fever in 28 patients (30.8%) were the main clinical signs; hyperleukocytosis with 23 cases (25.3) and anemia with 22 cases (24.2%), were the main laboratory abnormalities. On cerebral CT scan, sequelae with 33 cases (51.6%), acute stroke with 14 cases (21.9%) and acute meningoencephalitis with 8 cases (12.5%), were the most frequent. SEs symptomatic of acute brain disease, with 61 cases (67%), were dominated by infectious etiologies with 30 cases (33%) and acute strokes with 16 cases (17.6%). Among the non-acute or sequelae SEs of etiology, the sequelae of traumatic brain injury with 10 cases (11%) and the sequelae of stroke with 8 cases (8.8%) were the most represented. Conclusion: The aetiologies of SE are dominated in the Ouagadougou CHUs by CNS infections, acute or sequelae strokes and cranio-encephalic trauma. The fight against infectious diseases and the prevention of vascular risk factors will help reduce the frequency and severity of EMEs.