Prevalence of Medically Resistant Epilepsy in Saudi Arabia

Abstract

<b><i>Objectives:</i></b> The objective of this study was to evaluate the prevalence of medically resistant epilepsy (MRE) in our hospital and to compare the prevalence with that in other populations. <b><i>Methods:</i></b> We retrospectively analyzed the data of patients who visited the epilepsy clinics at King Fahd University Hospital, Al-Khobar, Saudi Arabia between January 2017 and December 2018. This study included patients aged ≥14 years who had at least 2 unprovoked seizures 24 h apart. Patients who had provoked seizure(s), paroxysmal events, or syncope or had incomplete medical records were excluded. The definition and classification of the International League Against Epilepsy were used. Moreover, we searched the En­glish literature using PubMed and Google Scholar to compare the prevalence of MRE between our population and other populations. <b><i>Results:</i></b> In total, 1,151 patients were screened, and 751 patients were included in the final analysis. Of the 751 patients, 229 (male: 56.3%, female: 43.7%; mean age: 32.07 years, and standard deviation, 12.2 years) had MRE, with a cumulative prevalence of 30%. The etiology was as follows: unknown, 63.3% (<i>n</i> = 145); structural, 31.9% (<i>n</i> = 73); genetic, 3.1% (<i>n</i> = 7); and infectious, 1.7% (<i>n</i> = 4). None of the patients had metabolic or immune-related etiologies. <b><i>Conclusion:</i></b> The prevalence of MRE in our population (30%) is close to that in other populations (30–36.5%). Early identification of such patients is crucial to improve their management.

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 ].…”

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

“…Despite the wide variety of ASM options available, approximately one-third of epileptic patients are resistant to these medications [ 3 ]. A retrospective study conducted in Saudi Arabia found that 30% of adult epileptic patients were ASM-resistant [ 4 ]. Hence, the International League Against Epilepsy (ILAE) has defined drug-resistant epilepsy as “a failure of adequate trials of two tolerated, appropriately chosen and used ASM schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom” [ 5 ].…”

Epilepsy Stigma Among University Students in Makkah: A Cross-Sectional Study

“…The cumulative prevalence of medically resistant epilepsy (MRE) in KSA is 30%. 6 , 7 Similarly, the prevalence of epilepsy is highest in adolescence and early childhood. The estimated prevalence for age 10–19 is 8.86 (95% CI (6.58–11.92) and for age 20–29 is 9.14 (95% CI (7.17–11.64).…”