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KMID : 1031120230130010013
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Journal of Epilepsy Research
2023 Volume.13 No. 1 p.13 ~ p.18
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The Frequency and Precipitating Factors for Breakthrough Seizures in Children with Epilepsy
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Abdullah Nasser Aldosari
Ahmed Alghamdi
Ayidh Alharthi
Abdullah Albuhayri
Yang Jae-Jin
Oh Seung-Eun
Mufleh Aldosari
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Abstract
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Background and Purpose : To determine the common precipitating factors for breakthrough seizures in children with epilepsy.
Methods : This retrospective study reviewed the charts of children with epilepsy who were followed up in the pediatric neurology clinic of King Fahad Hospital in Al-Baha region, Saudi Arabia, between January 2015 and August 2022. Children between 1 to 14 years of age who had epilepsy, as per the International League Against Epilepsy definition and received anti-seizure medication with a seizure-free period of at least 2 months before breakthrough seizure episode, were included in the study.
Results : Of the 108 children included in the study, the mean age was 6.8±1.6 years, and among them (55.5%) were male. Most parents (69.5%) were unaware of the triggering factors of seizure. The majority of patients (88%) reported at least one precipitating factor for breakthrough seizures and the most common one was systemic infection associated with fever (52.8%), and then non-compliance to medications in (34.3%) of the patients. In terms of the electroencephalogram, around 84 patients (77.8%) had abnormal electroencephalogram. Finally, monotherapy was maintained in 63.9% of patients.
Conclusions : We conclude that the most common trigger for breakthrough seizure is a systemic infection associated with fever and non-compliance to anti-seizure medications. Increasing the level of awareness by different methods may help limit or even prevent seizures from occurring. Randomized controlled trials could shed light on the adjustment of anti-seizure medications temporarily by increasing the dosage or giving extra doses during the infection to avoid breakthrough seizures.
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KEYWORD
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Children, Epilepsy, Breakthrough seizure, Precipitating factors, Saudi Arabia
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