Alghamdi Meshari, Alomari Nedaa, Alamri Aser F, Ghamdi Reema, Nazer Reema, Albloshi Sarah
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU), Riyadh, Saudi Arabia.
King Abdullah International Medical Research Centre (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU), Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia.
BMC Neurol. 2025 Apr 5;25(1):143. doi: 10.1186/s12883-025-04149-w.
BACKGROUND/OBJECTIVES: Drug-resistant epilepsy (DRE) is a significant global public health challenge affecting people with epilepsy (PWE). Despite the availability of multiple drug therapies, a significant number of PWE with DRE continue to experience frequent seizures. Current data on the prevalence of DRE and associated risk factors in the Saudi population is limited. This study aimed to estimate and characterize DRE among PWE and identify associated predictive factors.
A cross-sectional study was conducted on PWE who attended Neurology clinics at the National Guard Health Affairs in Riyadh, Saudi Arabia (NGHA-R) between June 2016 and February 2023. Data were collected from patient medical records. Descriptive analyses of continuous and categorical variables were performed. Comparisons between categorical data were conducted using Pearson's chi-squared test. Multivariable logistic regression was used to identify independent factors associated with the development of DRE. A p-value of < 0.05 was considered statistically significant.
A total of 350 patients were analyzed, with a confirmed DRE prevalence of 26.86% (94 out of 350). Age-specific analysis revealed that DRE was most prevalent in the 29-39 age group, accounting for 35.1% (33 out of 94) of cases. The primary predictor for DRE was focal seizure type (AOR = 1.85; 95% CI: 1.05-3.27, p = 0.03). Additionally, DRE patients were more likely to visit the emergency room. Among antiseizure medications, treatment regimens of valproic acid (p = 0.0008), carbamazepine (p = 0.0097), and lamotrigine (p = 0.037) showed significant associations with DRE status.
The prevalence of DRE in Saudi Arabia remains within the previously reported range of global prevalence. Frequent emergency department visits and the use of ASM polytherapy should be followed up closely to ensure early diagnosis of DRE and improve clinical outcomes.
背景/目的：耐药性癫痫（DRE）是一项重大的全球公共卫生挑战，影响着癫痫患者（PWE）。尽管有多种药物疗法可供使用，但大量患有DRE的PWE仍频繁发作。沙特人群中DRE患病率及相关危险因素的现有数据有限。本研究旨在估计并描述PWE中的DRE情况，并确定相关的预测因素。
对2016年6月至2023年2月期间在沙特阿拉伯利雅得国民警卫队卫生事务部（NGHA-R）神经科诊所就诊的PWE进行了一项横断面研究。数据从患者病历中收集。对连续变量和分类变量进行了描述性分析。分类数据之间的比较采用Pearson卡方检验。多变量逻辑回归用于确定与DRE发生相关的独立因素。p值<0.05被认为具有统计学意义。
共分析了350例患者，确诊的DRE患病率为26.86%（350例中的94例）。按年龄组分析显示，DRE在29-39岁年龄组中最为普遍，占病例的35.1%（94例中的33例）。DRE的主要预测因素是局灶性发作类型（调整后比值比[AOR]=1.85；95%置信区间[CI]：1.05-3.27，p=0.03）。此外，DRE患者更有可能前往急诊室就诊。在抗癫痫药物中，丙戊酸（p=0.0008）、卡马西平（p=0.0097）和拉莫三嗪（p=0.037）的治疗方案与DRE状态显示出显著关联。
沙特阿拉伯DRE的患病率仍在先前报告的全球患病率范围内。应密切随访频繁前往急诊科就诊的情况以及抗癫痫药物的联合使用情况，以确保DRE的早期诊断并改善临床结局。
