Acute seizure epidemiology in a neurological emergency department.

INTRODUCTION

Acute seizures in patients with epilepsy are a potential of source of neurological damage; their causes must be researched.

AIM

To explore the epidemiology of acute seizure exacerbations in patients with epilepsy in a neurological emergency department in Mexico City.

PATIENTS AND METHODS

Descriptive prospective study of patients with a previous diagnosis of epilepsy that receive medical care in an emergency department due to acute seizures.

RESULTS

100 patients were analyzed between august 2016 and January 2017. 86 patients presented with focal seizures, of which 76 were focal to bilateral tonic-clonic, 2 with impaired awareness and motor onset, 3 with impaired awareness and non-motor onset, 1 without impaired awareness and motor onset, and 4 without impaired awareness and non-motor onset. 14 patients had generalized seizures with motor onset. The causes of exacerbation were as follows: 26 patients due to antiepileptic dose omission, 21 due to a unknown cause, 19 due to infection, 13 due to sleep deprivation, 3 due to stress, 3 were catamenial, 2 due to alcohol abuse and 3 due to other reasons. Of the 26 patients with dose omission, 10 were due to forgetfulness, 7 refused to comply with their prescription, 6 could not afford to buy their prescription and 3 had their prescription changed by another doctor.

CONCLUSIONS

In Mexico, antiepileptic drug dose omission represents up to 25% of patients with acute seizure exacerbations; increased patient education on epilepsy hygiene measures may be an area of opportunity for reducing its frequency.