Factors associated with poor control in partial complex epilepsy

Evaluation of Seizure Frequency Distribution in Epileptic Patients with Normal and Abnormal Electroencephalogram in Al-Zahra Hospital of Isfahan

BACKGROUND

Epilepsy is a chronic neurological disorder characterized by seizure recurrence in patients. Electroencephalogram (EEG) has a diagnostic and prognostic role in the management of patients. Studies have shown a significant relation between seizure recurrence and abnormal EEG in newly diagnosed epileptic patients, and people with first episode of unprovoked seizure. The aim of this study is to evaluate seizure frequency in chronic epileptic patients on drug therapy based on normal or abnormal EEG.

MATERIALS AND METHODS

This prospective cohort study examined seizure recurrence in 59 epileptic patients (50.8% generalized, 49.2% focal) with normal and abnormal EEG. Data were recorded in patient medical file, and patients were followed by telephone call or visiting by neurologist.

RESULTS

In this study, 59 patients with a mean age of 29.58 ± 10.37 years were assessed that 42.4% of them were males and 57.6% were females. Seizure frequency in patient with specific abnormal EEG was significantly more than other patients (specific abnormal: 78.9%, nonspecific abnormal: 45.5%, and normal: 31%, P = 0.005). Seizure recurrence in patients on polytherapy was significantly higher than others (polytherapy: 76.9% and monotherapy: 27.3%, P < 0.001). In patient with abnormal imaging seizure, frequency was more than other patients which was nearly significant (P = 0.054).

CONCLUSION

Abnormal EEG and number of anticonvulsant drugs have a role in seizure recurrence in epileptic patients.

Prognosis and predictive factors of partial seizures in children

Our objective was to determine factors that influence the prognosis of cryptogenic partial seizures in children. In total, 233 patients were included in a hospital-based observational survey. Clinical characteristics of patients were reviewed and analyzed. Patients were characterized as having poor control of their seizures, or as having a > or = 50% decrease in their number of seizures. Student t test or Pearson's chi-square test were used to determine the differences between the groups with regard to clinical data. Multiple logistic regression analysis was used to investigate the independent effect of each risk factor. Complete seizure control was achieved in 71.7% of patients; improved seizure control was achieved in 13.3%; and poor seizure control was observed in 15.0%. Patients who had poor control of their seizures had a significantly younger age of onset (P = 0.03). In addition, chi-square analysis revealed that these patients had a higher seizure frequency (P < 0.001), and that seizure control was dependent on seizure type (P < 0.001). Multiple logistic regression analysis revealed that an initial seizure frequency of >3 per month (odds ratio [OR], 3.07; 95% confidence interval [CI], 1.37-6.88), age of onset (OR, 1.14; 95% CI, 1.0-1.31), and seizure type (OR, 0.48; 95% CI, 0.22-1.01) were predictors of poor seizure control.