A review of neurological disorders presenting at a paediatric neurology clinic and response to anticonvulsant therapy in Gambian children.

A clinical review of 128 children presenting at the paediatric neurology clinic of the Royal Victoria Hospital, The Gambia was conducted between July 2001 and January 2002. The aim was to assess the spectrum and burden of neurological disease presenting at this tertiary-level clinic and to evaluate the effectiveness of anticonvulsant therapy. The principal clinical diagnoses most frequently made were seizures (57%), neuromotor problems (15%) and developmental delay (11%). Many children also had associated developmental delay or learning difficulties (55%), speech and language problems (42%) and physical disability (36%). Although 65% were considered to need assistance in the community, only 11% were receiving such help. There were 73 children with seizures, 80% of whom had a greater than 50% reduction in seizure frequency following the start of simple anticonvulsant medication. Of the children who had experienced more than 100 convulsions during the previous year, only 50% responded similarly to treatment. This review emphasises the need for improved community services and accessible medical care for children with neurological problems in West Africa.