Clinical characteristics of epilepsy in resource‐limited communities in Punjab, Northwest India
Objectives To describe clinical characteristics of a community‐based epilepsy cohort from resource‐limited communities in Punjab, Northwest India. Methods The cohort was gathered following a two‐stage screening survey. We cross‐sectionally examined and followed up the cohort for one year. A panel of...
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| Veröffentlicht in: | Epilepsia open 2020-12, Vol.5 (4), p.582-595 |
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| creator | Singh, Gagandeep Singhal, Sachi Sharma, Suman Paul, Birinder S. Bansal, Namita Chaudhary, Anurag Sharma, Sarit Bansal, Rajnder K. Goraya, Jatinder S. Setia, Raj K. Sander, Josemir W. |
| description | Objectives
To describe clinical characteristics of a community‐based epilepsy cohort from resource‐limited communities in Punjab, Northwest India.
Methods
The cohort was gathered following a two‐stage screening survey. We cross‐sectionally examined and followed up the cohort for one year. A panel of neurologists assigned seizure types, syndromes, and putative etiologies and categorized drug responsiveness.
Results
The cohort of 240 included 161 (67.1%) men, 109 (45.4%) illiterates and 149 (62.1%) unemployed. Current age was >18 years in 155 (64.6%) but age at epilepsy onset was |
| doi_str_mv | 10.1002/epi4.12439 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7733663</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2471465717</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4769-750fc5a5f65915af8e627f386d85d5f4cd1e8a295764cbae66c4cdb589dfbcce3</originalsourceid><addsrcrecordid>eNp9kU9LHDEYh0NRqqiXfoAy0IsU1yYz-TO5CLJoXRD10J5DJvOmm2Um2SYzXfbWj9DP6Ccx21VRD-aSkDw8_PL-EPpE8CnBuPwGS0dPSUkr-QHtl1TgiSwrufPivIeOUlpgjIksCeH4I9qr8uKklPtITzvnndFdYeY6ajNAdGlwJhXBFtndwTKtC-eLCCmM0cD933-d690AbWFC34_eDQ7Shrgb_UI3J8VNiMN8BWkoZr51-hDtWt0lOHrcD9DPy4sf06vJ9e332fT8emKo4HIiGLaGaWY5k4RpWwMvha1q3tasZZaalkCtS8kEp6bRwLnJdw2rZWsbY6A6QGdb73JsemgN-CHqTi2j63Vcq6Cdev3i3Vz9Cn-UEHkYvMqC40dBDL_HnF_1LhnoOu0hjEnlgRLKmSAio1_eoIs8HJ-_lykueS0xrTP1dUuZGFKKYJ_DEKw25alNeep_eRn-_DL-M_pUVQbIFljlUtbvqNTF3YxupQ_5O6dB</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2469689048</pqid></control><display><type>article</type><title>Clinical characteristics of epilepsy in resource‐limited communities in Punjab, Northwest India</title><source>Wiley-Blackwell Open Access Titles</source><source>DOAJ Directory of Open Access Journals</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Singh, Gagandeep ; Singhal, Sachi ; Sharma, Suman ; Paul, Birinder S. ; Bansal, Namita ; Chaudhary, Anurag ; Sharma, Sarit ; Bansal, Rajnder K. ; Goraya, Jatinder S. ; Setia, Raj K. ; Sander, Josemir W.</creator><creatorcontrib>Singh, Gagandeep ; Singhal, Sachi ; Sharma, Suman ; Paul, Birinder S. ; Bansal, Namita ; Chaudhary, Anurag ; Sharma, Sarit ; Bansal, Rajnder K. ; Goraya, Jatinder S. ; Setia, Raj K. ; Sander, Josemir W.</creatorcontrib><description>Objectives
To describe clinical characteristics of a community‐based epilepsy cohort from resource‐limited communities in Punjab, Northwest India.
Methods
The cohort was gathered following a two‐stage screening survey. We cross‐sectionally examined and followed up the cohort for one year. A panel of neurologists assigned seizure types, syndromes, and putative etiologies and categorized drug responsiveness.
Results
The cohort of 240 included 161 (67.1%) men, 109 (45.4%) illiterates and 149 (62.1%) unemployed. Current age was >18 years in 155 (64.6%) but age at epilepsy onset was <18 years in 173 (72.1%). Epilepsies due to structural and metabolic causes were diagnosed in 99 (41.3%), but syndromic assignments were not possible in 97 (40.4%). After one year, drug‐resistant epilepsy was established in 74 (30.8%). Perinatal events (n = 35; 14.6%) followed by CNS infections (n = 32; 13.3%) and traumatic brain injury (n = 12; 5.0%) were common risk factors. Most of those with CNS infections (n = 19; 63.3%), perinatal antecedents (n = 23; 76.7%), and other acquired risk factors (n = 27; 90.0%) presented with epilepsy due to structural and metabolic causes. Perinatal events were the putative etiology for nearly 40.7% of generalized epilepsies due to structural and metabolic causes and 28.2% of all epilepsies with onset <10 years.
Significance
Existing classifications schemes should be better suited to field conditions in resource‐limited communities in low‐ and middle‐income countries. The finding of drug‐resistant epilepsy in nearly at least a third in a community‐based sample underscores an unmet need for enhancing services for this segment within healthcare systems. Perinatal events, CNS infections, and head injury account for a third of all epilepsies and hence preventative interventions focusing on these epilepsy risk factors should be stepped up.</description><identifier>ISSN: 2470-9239</identifier><identifier>EISSN: 2470-9239</identifier><identifier>DOI: 10.1002/epi4.12439</identifier><identifier>PMID: 33336129</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>classification ; Convulsions & seizures ; Drug resistance ; Epilepsy ; epileptic syndromes ; etiology ; Family income ; Full‐length Original Research ; Illiteracy ; Infections ; perinatal accidents ; prevention ; Risk factors ; Sociodemographics ; Traumatic brain injury</subject><ispartof>Epilepsia open, 2020-12, Vol.5 (4), p.582-595</ispartof><rights>2020 The Authors. published by Wiley Periodicals LLC on behalf of International League Against Epilepsy</rights><rights>2020 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.</rights><rights>2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4769-750fc5a5f65915af8e627f386d85d5f4cd1e8a295764cbae66c4cdb589dfbcce3</citedby><cites>FETCH-LOGICAL-c4769-750fc5a5f65915af8e627f386d85d5f4cd1e8a295764cbae66c4cdb589dfbcce3</cites><orcidid>0000-0001-6661-3553 ; 0000-0002-0906-0267 ; 0000-0001-6041-9661</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733663/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733663/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1411,11543,27903,27904,45553,45554,46030,46454,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33336129$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Singh, Gagandeep</creatorcontrib><creatorcontrib>Singhal, Sachi</creatorcontrib><creatorcontrib>Sharma, Suman</creatorcontrib><creatorcontrib>Paul, Birinder S.</creatorcontrib><creatorcontrib>Bansal, Namita</creatorcontrib><creatorcontrib>Chaudhary, Anurag</creatorcontrib><creatorcontrib>Sharma, Sarit</creatorcontrib><creatorcontrib>Bansal, Rajnder K.</creatorcontrib><creatorcontrib>Goraya, Jatinder S.</creatorcontrib><creatorcontrib>Setia, Raj K.</creatorcontrib><creatorcontrib>Sander, Josemir W.</creatorcontrib><title>Clinical characteristics of epilepsy in resource‐limited communities in Punjab, Northwest India</title><title>Epilepsia open</title><addtitle>Epilepsia Open</addtitle><description>Objectives
To describe clinical characteristics of a community‐based epilepsy cohort from resource‐limited communities in Punjab, Northwest India.
Methods
The cohort was gathered following a two‐stage screening survey. We cross‐sectionally examined and followed up the cohort for one year. A panel of neurologists assigned seizure types, syndromes, and putative etiologies and categorized drug responsiveness.
Results
The cohort of 240 included 161 (67.1%) men, 109 (45.4%) illiterates and 149 (62.1%) unemployed. Current age was >18 years in 155 (64.6%) but age at epilepsy onset was <18 years in 173 (72.1%). Epilepsies due to structural and metabolic causes were diagnosed in 99 (41.3%), but syndromic assignments were not possible in 97 (40.4%). After one year, drug‐resistant epilepsy was established in 74 (30.8%). Perinatal events (n = 35; 14.6%) followed by CNS infections (n = 32; 13.3%) and traumatic brain injury (n = 12; 5.0%) were common risk factors. Most of those with CNS infections (n = 19; 63.3%), perinatal antecedents (n = 23; 76.7%), and other acquired risk factors (n = 27; 90.0%) presented with epilepsy due to structural and metabolic causes. Perinatal events were the putative etiology for nearly 40.7% of generalized epilepsies due to structural and metabolic causes and 28.2% of all epilepsies with onset <10 years.
Significance
Existing classifications schemes should be better suited to field conditions in resource‐limited communities in low‐ and middle‐income countries. The finding of drug‐resistant epilepsy in nearly at least a third in a community‐based sample underscores an unmet need for enhancing services for this segment within healthcare systems. Perinatal events, CNS infections, and head injury account for a third of all epilepsies and hence preventative interventions focusing on these epilepsy risk factors should be stepped up.</description><subject>classification</subject><subject>Convulsions & seizures</subject><subject>Drug resistance</subject><subject>Epilepsy</subject><subject>epileptic syndromes</subject><subject>etiology</subject><subject>Family income</subject><subject>Full‐length Original Research</subject><subject>Illiteracy</subject><subject>Infections</subject><subject>perinatal accidents</subject><subject>prevention</subject><subject>Risk factors</subject><subject>Sociodemographics</subject><subject>Traumatic brain injury</subject><issn>2470-9239</issn><issn>2470-9239</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kU9LHDEYh0NRqqiXfoAy0IsU1yYz-TO5CLJoXRD10J5DJvOmm2Um2SYzXfbWj9DP6Ccx21VRD-aSkDw8_PL-EPpE8CnBuPwGS0dPSUkr-QHtl1TgiSwrufPivIeOUlpgjIksCeH4I9qr8uKklPtITzvnndFdYeY6ajNAdGlwJhXBFtndwTKtC-eLCCmM0cD933-d690AbWFC34_eDQ7Shrgb_UI3J8VNiMN8BWkoZr51-hDtWt0lOHrcD9DPy4sf06vJ9e332fT8emKo4HIiGLaGaWY5k4RpWwMvha1q3tasZZaalkCtS8kEp6bRwLnJdw2rZWsbY6A6QGdb73JsemgN-CHqTi2j63Vcq6Cdev3i3Vz9Cn-UEHkYvMqC40dBDL_HnF_1LhnoOu0hjEnlgRLKmSAio1_eoIs8HJ-_lykueS0xrTP1dUuZGFKKYJ_DEKw25alNeep_eRn-_DL-M_pUVQbIFljlUtbvqNTF3YxupQ_5O6dB</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Singh, Gagandeep</creator><creator>Singhal, Sachi</creator><creator>Sharma, Suman</creator><creator>Paul, Birinder S.</creator><creator>Bansal, Namita</creator><creator>Chaudhary, Anurag</creator><creator>Sharma, Sarit</creator><creator>Bansal, Rajnder K.</creator><creator>Goraya, Jatinder S.</creator><creator>Setia, Raj K.</creator><creator>Sander, Josemir W.</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6661-3553</orcidid><orcidid>https://orcid.org/0000-0002-0906-0267</orcidid><orcidid>https://orcid.org/0000-0001-6041-9661</orcidid></search><sort><creationdate>202012</creationdate><title>Clinical characteristics of epilepsy in resource‐limited communities in Punjab, Northwest India</title><author>Singh, Gagandeep ; Singhal, Sachi ; Sharma, Suman ; Paul, Birinder S. ; Bansal, Namita ; Chaudhary, Anurag ; Sharma, Sarit ; Bansal, Rajnder K. ; Goraya, Jatinder S. ; Setia, Raj K. ; Sander, Josemir W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4769-750fc5a5f65915af8e627f386d85d5f4cd1e8a295764cbae66c4cdb589dfbcce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>classification</topic><topic>Convulsions & seizures</topic><topic>Drug resistance</topic><topic>Epilepsy</topic><topic>epileptic syndromes</topic><topic>etiology</topic><topic>Family income</topic><topic>Full‐length Original Research</topic><topic>Illiteracy</topic><topic>Infections</topic><topic>perinatal accidents</topic><topic>prevention</topic><topic>Risk factors</topic><topic>Sociodemographics</topic><topic>Traumatic brain injury</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Singh, Gagandeep</creatorcontrib><creatorcontrib>Singhal, Sachi</creatorcontrib><creatorcontrib>Sharma, Suman</creatorcontrib><creatorcontrib>Paul, Birinder S.</creatorcontrib><creatorcontrib>Bansal, Namita</creatorcontrib><creatorcontrib>Chaudhary, Anurag</creatorcontrib><creatorcontrib>Sharma, Sarit</creatorcontrib><creatorcontrib>Bansal, Rajnder K.</creatorcontrib><creatorcontrib>Goraya, Jatinder S.</creatorcontrib><creatorcontrib>Setia, Raj K.</creatorcontrib><creatorcontrib>Sander, Josemir W.</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Epilepsia open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Singh, Gagandeep</au><au>Singhal, Sachi</au><au>Sharma, Suman</au><au>Paul, Birinder S.</au><au>Bansal, Namita</au><au>Chaudhary, Anurag</au><au>Sharma, Sarit</au><au>Bansal, Rajnder K.</au><au>Goraya, Jatinder S.</au><au>Setia, Raj K.</au><au>Sander, Josemir W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical characteristics of epilepsy in resource‐limited communities in Punjab, Northwest India</atitle><jtitle>Epilepsia open</jtitle><addtitle>Epilepsia Open</addtitle><date>2020-12</date><risdate>2020</risdate><volume>5</volume><issue>4</issue><spage>582</spage><epage>595</epage><pages>582-595</pages><issn>2470-9239</issn><eissn>2470-9239</eissn><abstract>Objectives
To describe clinical characteristics of a community‐based epilepsy cohort from resource‐limited communities in Punjab, Northwest India.
Methods
The cohort was gathered following a two‐stage screening survey. We cross‐sectionally examined and followed up the cohort for one year. A panel of neurologists assigned seizure types, syndromes, and putative etiologies and categorized drug responsiveness.
Results
The cohort of 240 included 161 (67.1%) men, 109 (45.4%) illiterates and 149 (62.1%) unemployed. Current age was >18 years in 155 (64.6%) but age at epilepsy onset was <18 years in 173 (72.1%). Epilepsies due to structural and metabolic causes were diagnosed in 99 (41.3%), but syndromic assignments were not possible in 97 (40.4%). After one year, drug‐resistant epilepsy was established in 74 (30.8%). Perinatal events (n = 35; 14.6%) followed by CNS infections (n = 32; 13.3%) and traumatic brain injury (n = 12; 5.0%) were common risk factors. Most of those with CNS infections (n = 19; 63.3%), perinatal antecedents (n = 23; 76.7%), and other acquired risk factors (n = 27; 90.0%) presented with epilepsy due to structural and metabolic causes. Perinatal events were the putative etiology for nearly 40.7% of generalized epilepsies due to structural and metabolic causes and 28.2% of all epilepsies with onset <10 years.
Significance
Existing classifications schemes should be better suited to field conditions in resource‐limited communities in low‐ and middle‐income countries. The finding of drug‐resistant epilepsy in nearly at least a third in a community‐based sample underscores an unmet need for enhancing services for this segment within healthcare systems. Perinatal events, CNS infections, and head injury account for a third of all epilepsies and hence preventative interventions focusing on these epilepsy risk factors should be stepped up.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>33336129</pmid><doi>10.1002/epi4.12439</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0001-6661-3553</orcidid><orcidid>https://orcid.org/0000-0002-0906-0267</orcidid><orcidid>https://orcid.org/0000-0001-6041-9661</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley-Blackwell Open Access Titles; DOAJ Directory of Open Access Journals; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | classification Convulsions & seizures Drug resistance Epilepsy epileptic syndromes etiology Family income Full‐length Original Research Illiteracy Infections perinatal accidents prevention Risk factors Sociodemographics Traumatic brain injury |
| title | Clinical characteristics of epilepsy in resource‐limited communities in Punjab, Northwest India |
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