- 作者：Wafaa M.A. Farghaly ; Hamdy N. El-Tallawy ; Tarek A. Rageh ; Eman M. Mohamed ; Nabil A. Metwally ; Ghaydaa A. Shehata ; Reda Badry ; Mohamed A. Abd-Elhamed
- 关键词：Intractable epilepsy ; Predictors ; Epidemiology ; Psychogenic non-epileptic seizures
- 刊名：Seizure
- 出版年：2013
- 出版时间：October, 2013
- 年：2013
- 卷：22
- 期：8
- 页码：611-616
- 全文大小：475 K
Background
Despite advances in treating epilepsy, uncontrolled epilepsy continues to be a major clinical problem. Therefore, this work aimed to study the epidemiology of uncontrolled epilepsy in Al-Kharga District, New Valley.Methods
This study was carried out in 3 stages via door-to-door screening of the total population (62,583 persons). All suspected cases of epilepsy were subjected to case ascertainment, conventional ElectroEncephaloGraphy (EEG), and the Stanford-Binet Intelligence Scale. Patients who had been receiving suitable anti-epileptic drugs (AEDs) over the previous 6 months and were having active seizures were considered uncontrolled, according to Ohtsuka et al. The patients underwent serum AED level estimation, video EEG monitoring, and brain MRIs. Fifty age- and gender-matched patients with controlled epilepsy were chosen for statistical analysis and compared with true intractable patients.
Results
A total of 437 patients with epilepsy were identified, 30.7 % of whom (n = 134/437) were uncontrolled, with a prevalence of 2.1/1000. A total of 52.2 % of uncontrolled patients (n = 70/134) were inappropriately treated, while 47.8 % (n = 64/134) were compliant with appropriate treatments. Video monitoring EEG of compliant uncontrolled patients demonstrated that 78.1 % patients (n = 50/64) had definite epilepsy, while 21.9 % (n = 14/64) had psychogenic non-epileptic seizures (PNES). A logistic regression analysis revealed that status epilepticus, focal seizures, and mixed seizure types were risk factors for intractability.