Epidemiology of uncontrolled epilepsy in the Al-Kharga District,New Valley,Egypt |
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Authors: | 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 |
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Affiliation: | 1. Department of Neurology & Psychiatry, Assiut University, Egypt;2. Department of Public Health & Community Medicine, Assiut University, Assiut, Egypt;3. Alazhar University, Assiut Branch, Egypt |
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Abstract: | BackgroundDespite 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.MethodsThis 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.23 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.ResultsA 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. |
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Keywords: | Intractable epilepsy Predictors Epidemiology Psychogenic non-epileptic seizures |
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