Demographic and Clinical Predictors of Drug Response in Epileptic Children in Jeddah

Abstract

Epilepsy is a chronic neurological disease of the brain. Over 20 antiseizure medications are available on the market, but a third of patients still have drug-resistant epilepsy. This study was designed to assess the impact of the demographic and clinical characteristics of epileptic children on their likelihood of developing drug resistance. This study was a multicenter, hospital-based, cross-sectional, case–control study of pediatric patients diagnosed with epilepsy in Jeddah, Saudi Arabia. The study included 101 children with epilepsy. Fifty-six patients showed good response to antiseizure medications (ASMs), and forty-five patients had a poor response. A statistically significant good response to ASMs was reported among younger patients, those who did not report parental consanguinity, those who did not have a family history of epilepsy, and those diagnosed with partial seizures, with no reported adverse effects. The levetiracetam regimen was statistically significant regarding the responsiveness to ASMs. Patients on a monotherapy regimen elicited a significantly better response to levetiracetam than patients on polytherapy (p < 0.001). No significant association was found between the response to ASMs and the sex, nationality, body mass index, complete blood count, or vitamin B12 level. In conclusion, the ASM response in epileptic patients can be predicted by knowing the patient’s demographic and epileptic history. However, the complete blood count and vitamin B12 level failed to predict patients’ response to ASMs.

Demographics, Clinical Characteristics, and Management Strategies of Epilepsy in Saudi Arabia: A Systematic Review

“…Our review included 13 articles covering 3801 people with epilepsy (PWE). Only four studies were retrospective [ 11 , 21 - 23 ] and nine were cross-sectional [ 17 , 24 - 31 ].…”

“…All studies assessed the general characteristics of patients with epilepsy. As for the patient's age, it ranged from 0 to 90 years and 8 studies showed a male predominance [ 11 , 17 , 21 , 22 , 25 , 26 , 28 , 31 ]. According to the family history of epilepsy, it was seen only in five studies [ 17 , 22 , 24 , 25 , 30 ] and showed a prevalence ranging from 6% to 24.9% [ 22 , 30 ].…”

“…As for the clinical characteristics of patients with epilepsy included in this systemic review, five studies showed a higher prevalence of generalized tonic-clonic epilepsy type [ 11 , 17 , 23 , 26 , 31 ], five studies showed a predominance of focal epilepsy type [ 21 , 22 , 25 , 27 , 28 ], and three studies did not assess the epilepsy type [ 24 , 29 , 30 ].…”

“…Nine studies assessed the management strategy of the studied patients. Of these studies, five studies showed a higher prevalence of monotherapy regimens [ 17 , 21 , 22 , 25 , 26 ], three studies showed a higher prevalence of polytherapy anti-epileptic medicine (AEM) regimens, while three studies did not assess the management strategy [ 27 , 28 , 31 ].…”

“…According to estimates, there were 6.54 epileptic patients for every 1000 people in Saudi Arabia in 2015 [ 16 ]. Regarding ASM, the findings of an earlier study revealed that drug-resistant epilepsy affected 45% of the Saudi participants [ 17 ]. A proportion that was concerningly greater than the frequency of drug-resistant epilepsy documented in other studies [ 18 , 19 ].…”