Role of the CT-scan in the care of epileptic patients in Ivory coast Volume 20, issue 4, Octobre, Novembre, Décembre 2008

Service de Neurologie CHU de Yopougon, 21 BP 632 Abidjan 21, Côte d’Ivoire, Service de Neurologie CHU de Cocody, BP V 13 Abidjan, Côte d’Ivoire

A prospective and comparative study took place in the neurology department of teaching hospital of Yopougon in Abidjan Ivory Coast. The aim of the study was to determine the contribution of the CT-scan in the care of epileptic adults. Patients were divided in two groups : those with CT-scan and those without CT-scan. The two groups have been compared with a chi2 test concerning the classification, the aetiologies and the treatment of the epilepsy. 50,7 % of the patients had a cerebral CT. In patients without CT-scan epilepsies of unknown aetiology represented 94.3 % of cases while in those with CT-scan epilepsies of unknown aetiology represented only 58.3 % of cases. The aetiologies which have been identified by the CT-scan were due to infections in 33.3 % of cases (5/15), most frequently cerebral toxoplasmosis (60 %), to cranial traumatism in 26.7 % (4/15), to strokes in 20 % (3/15), to brain tumours only in 6.7 % (1/15), and to alcohol with cortical atrophy in 13.3 % (2/15). Phenobarbital have been significantly more used in the group of patients without scan than in the group with (45.7 % versus 13.9 % p = 0.003) while carbamazepine have been preferred in the group with CT-scan (33.3 % versus 05.7 % ; p = 0.003). This study shows that the advent of the CT-Scan in Ivory coast has contributed to a better care of epileptic patients and suggests to improve accessibility to the neurooradiological equipments in the publics hospitals of the country.