Ullah Shakir, Ali Niaz, Khan Adnan, Ali Saad, Nazish Haleema Rehana
Pharmacology/Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan.
Center for Neuroscience, Shantou University Medical College, Shantou, China.
Front Neurol. 2018 Nov 6;9:845. doi: 10.3389/fneur.2018.00845. eCollection 2018.
Previous studies have shown that Khyber Pakhtunkhwa, Pakistan has a high incidence of epilepsy and a high proportion of low socioeconomic background and high treatment gap. Considering the changes over the past 20 years little is known about the current epidemiological characteristics of epilepsy in Khyber Pakhtunkhwa, Pakistan. The current study was focused to find the impact of various contributing factors on the clinical response to anti-epileptic drugs in the KP population, Pakistan. A total of 315 participants aged 19.1 ± 8.6 years were examined. Mean age of the patients was 18 ± 8.1 year. Epilepsy was high in male patients (64.39%) and urban areas (60.1%). Mostly, 88.6% of patients were belonging to low socioeconomic status background. 42.4% patients have positive family history for epilepsy and 42.8% patients had consanguineous marriages. Middle SES class patients (OR, 2.22 [CI, 0.54-9.1]) were slightly associated with controlled response to CBZ and VPA therapy. Absence seizure (OR, 1.16 [CI, 0.59-2.3]), and Complex partial seizure (OR, 1.29 [CI, 0.58-6.3]) showed good response to CBZ therapy while, Myoclonic seizure (OR, 2.23 [CI, 0.05-8.8]) was responsive to VPA therapy. However, non-compliance ( 0.82, < 0.0001) and nature of seizures ( 0.83, < 0.0001) were associated with the high risk for poor response to both CBZ and VPA therapy. Epilepsy was high in male patients and in urban areas. Most patients were belonging to low socioeconomic status. Non-compliance, low socioeconomic and nature of seizures strongly predict poor clinical response of anti-epileptic drugs therapy.
以往研究表明,巴基斯坦开伯尔-普赫图赫瓦省癫痫发病率高,社会经济背景低下的比例高,治疗缺口大。考虑到过去20年的变化,对于巴基斯坦开伯尔-普赫图赫瓦省目前癫痫的流行病学特征知之甚少。当前研究旨在探究各种影响因素对巴基斯坦开伯尔-普赫图赫瓦省人群抗癫痫药物临床反应的影响。共检查了315名年龄为19.1±8.6岁的参与者。患者的平均年龄为18±8.1岁。男性患者(64.39%)和城市地区(60.1%)的癫痫发病率较高。大多数患者(88.6%)社会经济地位低下。42.4%的患者有癫痫家族史阳性,42.8%的患者有近亲婚姻。中等社会经济阶层患者(比值比,2.22[可信区间,0.54-9.1])与卡马西平和丙戊酸治疗的控制反应略有关联。失神发作(比值比,1.16[可信区间,0.59-2.3])和复杂部分性发作(比值比,1.29[可信区间,0.58-6.3])对卡马西平治疗反应良好,而肌阵挛发作(比值比,2.23[可信区间,0.05-8.8])对丙戊酸治疗有反应。然而,不依从(χ²=0.82,P<0.0001)和发作类型(χ²=0.83,P<0.0001)与卡马西平和丙戊酸治疗反应不佳的高风险相关。男性患者和城市地区的癫痫发病率较高。大多数患者社会经济地位低下。不依从、社会经济地位低下和发作类型强烈预示抗癫痫药物治疗的临床反应不佳。