Department of Neurology, College of Medicine, Imam Abdul Rahman Bin Faisal University, King Fahd University Hospital, Dammam, Saudi Arabia.
Corresponding author: Danah Aljaafari, MD, Department of Neurology, College of Medicine, Imam Abdul Rahman Bin Faisal University, 2835 King Faisal Rd, Dammam 34212, Saudi Arabia (
Prim Care Companion CNS Disord. 2021 Dec 9;23(6):20m02904. doi: 10.4088/PCC.20m02904.
To determine the etiologies of epilepsy in a cohort of patients using the International League Against Epilepsy 2017 classification system and to determine frequencies of preventable causes and their clinical characteristics. Epileptic patients in neurology clinics at a tertiary care hospital were prospectively recruited from June 1, 2018, to November 30, 2018. Patients were divided according to their respective etiologic categories. Traumatic brain injury, stroke, hypoxic-ischemic encephalopathy, and central nervous system infections were considered preventable etiologies. A total of 160 patients were included in the study. Of these patients, 61 had epilepsy of unknown etiology, while among the remaining 99 patients in whom etiology could be identified, traumatic brain injury was the most frequent overall cause with 17 (17.2%) cases. Frequencies in other etiologies were genetic (idiopathic generalized epilepsy): n = 14, stroke: n = 13, hypoxic-ischemic encephalopathy: n = 13, cerebral tumors: n = 10, mesial temporal sclerosis: n = 9, cortical malformation: n = 7, and other structural pathologies: n = 5. Other rarer causes (including central nervous system infections) had less than 5 patients each. When the preventable etiologies were grouped, they formed 46 of 99 patients (46.5%) with identifiable etiology. Seizure control was mostly satisfactory in the total sample (126/160 [78.8%]), including patients with preventable etiologies, of whom 50% were on polytherapy. Epilepsies with preventable etiologies are common in our clinics. Studies are needed in other centers to identify epilepsy etiologies and confirm our findings, which may help determine better strategies for primary prevention of epilepsy.
使用 2017 年国际抗癫痫联盟分类系统确定癫痫患者的病因，并确定可预防病因的频率及其临床特征。
本前瞻性研究于 2018 年 6 月 1 日至 11 月 30 日在一家三级护理医院的神经病学诊所招募癫痫患者。根据病因分类将患者分组。脑外伤、卒中、缺氧缺血性脑病和中枢神经系统感染被认为是可预防的病因。
共纳入 160 例患者。其中，61 例癫痫病因不明，其余 99 例可明确病因的患者中，脑外伤是最常见的病因，共 17 例（17.2%）。其他病因的频率依次为遗传（特发性全面性癫痫）：n=14 例，卒中：n=13 例，缺氧缺血性脑病：n=13 例，脑肿瘤：n=10 例，海马硬化：n=9 例，皮质发育不良：n=7 例，其他结构性病变：n=5 例。其他罕见病因（包括中枢神经系统感染）每例患者少于 5 例。将可预防病因分组后，99 例可明确病因的患者中，46 例（46.5%）为可预防病因。160 例患者中，总体上有 126 例（78.8%）癫痫控制满意，包括可预防病因患者，其中 50%患者接受了多药治疗。
在我们的临床实践中，可预防病因的癫痫较为常见。需要在其他中心开展研究以确定癫痫病因并验证我们的发现，这可能有助于确定更好的癫痫一级预防策略。
