Neurocognitive outcomes among children with epilepsy in sub-Saharan Africa: a systematic review

Background Childhood epilepsy is one of the most common neurologic disorders, with a global prevalence estimated between 4 and 7 per 1000 children, with higher prevalence in LMICs, including sub-Saharan Africa. Beyond seizure recurrence, epilepsy is recognized as a disorder of neurodevelopment with broad cognitive and behavioral consequences. The objectives of this review were to evaluate research and summarize results on neurocognitive outcomes among children with epilepsy. Methods We searched PubMed, Scopus, ScienceDirect, EMBASE, APA PsycNet, NeuroBITE, and the African Journals Online (AJOL) databases, and also a manual search was also used to get studies on neurocognitive outcomes among children with epilepsy, which was done in sub-Saharan African countries regardless of publication year. The heterogeneity in study design, assessment tool, cognitive domain, and definition of outcomes prevents us from doing a meta-analysis. The results are thus presented narratively with regard to relevant cognitive domains. Result A total of eleven studies from six Sub-Saharan African countries were included in this review. The magnitude of cognitive impairment in the included studies ranges from 21.9% to 69.3% in children with epilepsy. The cognitive domains that were frequently mentioned include global IQ, attention span, memory, and school performance. Conclusion Cognitive impairment is a frequent comorbidity in children with epilepsy in sub-Saharan Africa, affecting multiple cognitive domains. Routine cognitive screening and early multidisciplinary management are needed to improve outcomes.