Vongkasamchai Nutthaya, Lertsinudom Sunee, Topark-Ngarm Acharawan, Peansukwech Udomlack, Sawanyawisuth Kittisak, Tiamkao Somsak
Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand ; Integrated Epilepsy Research Group, Khon Kaen University, Khon Kaen 40002, Thailand.
Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Neurol Res Int. 2015;2015:659189. doi: 10.1155/2015/659189. Epub 2015 Nov 12.
Background and Objective. Provocative factors are one causative factor of seizure attacks in persons with epilepsy (PWE). There are limited data of prevalence and major provocative factors in Asian populations. Methods. This study was performed at the Epilepsy Clinic, Khon Kaen University Hospital. The patients who aged 15 years or over, who had been treated at least 3 months with at least one antiepileptic drug, and who were followed up for at least one year were included. Data of seizure control and triggers were collected retrospectively from medical records. Data analysis was performed to identify independent provocative factors. Results. A total of 382 PWE met the study criteria. The mean age was 40.4 ± 0.8 years. Approximately 44% of the patients had at least one provocative factor. By multivariate analysis, the independent provocative factors with the first three highest adjusted odds ratios were sleep deprivation (adjusted OR = 8.64, 95% CI 3.73-19.99), alcohol consumption (adjusted OR = 6.76, 95% CI 1.44-31.78), and feeling stressful (adjusted OR = 2.97, 95% CI 1.29-6.86). Conclusion. Almost half of seizure attacks may be caused by provocative factors in Thai PWEs and some factors may be preventable. Avoidance of these factors should be emphasized to epilepsy patients for improving clinical outcomes and quality of life.
背景与目的。诱发因素是癫痫患者（PWE）癫痫发作的一个致病因素。关于亚洲人群中其患病率及主要诱发因素的数据有限。方法。本研究在孔敬大学医院癫痫诊所开展。纳入年龄15岁及以上、接受至少一种抗癫痫药物治疗至少3个月且随访至少一年的患者。从病历中回顾性收集癫痫控制及诱发因素的数据。进行数据分析以确定独立的诱发因素。结果。共有382例癫痫患者符合研究标准。平均年龄为40.4±0.8岁。约44%的患者至少有一个诱发因素。通过多因素分析，调整后比值比最高的前三个独立诱发因素为睡眠剥夺（调整后OR = 8.64，95%CI 3.73 - 19.99）、饮酒（调整后OR = 6.76，95%CI 1.44 - 31.78）和感到压力（调整后OR = 2.97，95%CI 1.29 - 6.86）。结论。在泰国癫痫患者中，近一半的癫痫发作可能由诱发因素引起，且一些因素是可预防的。应向癫痫患者强调避免这些因素，以改善临床结局和生活质量。
