Clinical, etiological, and evolutionary aspects of epilepsy with developmental encephalopathy in children at the Gynecology, Obstetrics, and Pediatrics Hospital in Yaoundé (Cameroon)

Abstract

Introduction: According to the ILAE 2017 classification, epilepsies with developmental encephalopathy in children are characterized by severe seizures, specific EEG abnormalities, and an impact on psychomotor development. The objective was to describe the clinical, etiological, and evolutionary aspects of this type of epilepsy.

Methodology: This was a retrospective longitudinal study conducted from January 1, 2015, to August 31, 2025. It included 98 children followed for epilepsy with developmental encephalopathy. The variables studied were sociodemographic data, etiological factors, type of epilepsy, EEG abnormalities, and medical imaging.

Results: The average age at onset of seizures was 4.8±3.3 months (sex ratio M/F: 2.38). Generalized seizures were the most common (95.9%), particularly epileptic spasms (50.0%). The main etiological factors were perinatal asphyxia (32.7%), severe malaria (14.3%), cytomegalovirus infection (8.2%), and a family history of epilepsy (18%). Psychomotor development was abnormal (52%). The main epileptic syndromes found were: infantile spasms syndrome (61.2%), Dravet syndrome (14.2%), and epilepsies with atonic myoclonic seizures (11.2%). EEG abnormalities were dominated by hypsarrhythmia (61.2%). Dual therapy was the most commonly used treatment protocol (79.6%). After 12 months of treatment, 21.4% had persistent and/or worsening seizures and 18.4% had persistent electroclinical abnormalities with cognitive impairment in 49%.

Conclusion: Epilepsy with developmental encephalopathy was characterized by early onset, was more common in boys, was mainly secondary to preventable perinatal causes, and was associated with drug resistance and poor prognosis.