Alkhotani Amal Mohammed, Abualela Hanadi
From the College of Medicine, Umm Al-Qura University, Al-Aabdia, Makkah, Saudi Arabia.
From the Department of Neuroscience, King Abdullah Medical City, Makkah, Saudi Arabia.
Ann Saudi Med. 2025 May-Jun;45(3):198-206. doi: 10.5144/0256-4947.2025.198. Epub 2025 Jun 5.
A functional seizure (FS) is a paroxysmal event that resembles epileptic seizures (ES) but without associated changes in cortical activity.
To assess the prevalence of FS among ES patients admitted to the epilepsy monitoring unit (EMU) in King Abdullah Medical City (KAMC).
A retrospective cohort study.
EMU at KAMC.
EMU database from 2015 to 2023 were reviewed. Patients were included in the study if they had a diagnosis of epilepsy and recorded seizure during admission.
The prevalence and the predictors of FS developments among patients with ES.
198 patients.
The prevalence of FS was 10.6%. Significant risk factors associated with FS were income (18.6% vs 8.4% =.048), focal epilepsy (66.7% vs 33.3% for generalized =.004), frontal localization (38.5 versus 14.3% of temporal localization =.041), on 5 antiseizure medications (ASMs) (75% versus 3% of on one ASM =.001), receiving phenytoin (PHY) (46.2% vs other ASMs, =.001), on psychiatric medications before EMU (29.4% vs. 8.8%) and those on the same medication after the EMU (35.6 % vs. 3.3%) (=.008 and .001, respectively). Around 33.3% of FS cases had a major depressive disorder (MDD), 19% had a generalized anxiety disorder (GAD) and 14.3% were diagnosed with both MDD and GAD compared to without FS 4%, 2.3%, and 4.5%, respectively (=.001). Multiple stepwise logistic regression analysis identified additional risk factors including male gender (odds ratio [OR] 3.0, 95% CI: 2.4-47.3; =.048), shorter epilepsy duration (OR 0.8, 95% CI: 0.6-1.0; =.046), history of head trauma (OR 5.5, 95% CI: 1.4-25.7; =.047) and intellectual disability (OR 17.5, 95% CI: 1.4-39.2; =.044).
Patients with combined disorders are more likely to be male, shorter epilepsy duration, had salary income, focal epilepsy, frontal localization, history of head trauma, intellectual disability and be on higher ASMs, phenytoin as ASMs, depression, anxiety and more likely to be on psychiatric treatment.
The study was a retrospective study.
功能性癫痫发作（FS）是一种阵发性事件，类似于癫痫发作（ES），但皮质活动无相关变化。
评估阿卜杜拉国王医疗城（KAMC）癫痫监测单元（EMU）收治的ES患者中FS的患病率。
一项回顾性队列研究。
KAMC的EMU。
回顾了2015年至2023年的EMU数据库。如果患者被诊断为癫痫且入院期间有癫痫发作记录，则纳入本研究。
ES患者中FS发生的患病率和预测因素。
198例患者。
FS的患病率为10.6%。与FS相关的显著危险因素包括收入（18.6%对8.4%，P = 0.048）、局灶性癫痫（66.7%对全身性癫痫的33.3%，P = 0.004）、额叶定位（38.5%对颞叶定位的14.3%，P = 0.041）、服用5种抗癫痫药物（ASM）（75%对服用1种ASM的3%，P = 0.001）、服用苯妥英（PHY）（46.2%对其他ASM，P = 0.001）、在进入EMU前服用精神科药物（29.4%对8.8%）以及在进入EMU后继续服用相同药物（35.6%对3.3%）（分别为P = 0.008和P = 0.001）。约33.3%的FS病例患有重度抑郁症（MDD），19%患有广泛性焦虑症（GAD），14.3%被诊断为同时患有MDD和GAD，而无FS的患者分别为4%、2.3%和4.5%（P = 0.001）。多步逻辑回归分析确定了其他危险因素，包括男性（比值比[OR] 3.0，95%置信区间：2.4 - 47.3；P = 0.048）、癫痫病程较短（OR 0.8，95%置信区间：0.6 - 1.0；P = 0.046）、头部外伤史（OR 5.5，95%置信区间：1.4 - 25.7；P = 0.047）和智力残疾（OR 17.5，95%置信区间：1.4 - 39.2；P = 0.044）。
合并症患者更可能为男性、癫痫病程较短、有薪资收入、患有局灶性癫痫、额叶定位、有头部外伤史、智力残疾，服用较多的ASM、服用苯妥英作为ASM、患有抑郁症、焦虑症，且更可能接受精神科治疗。
本研究为回顾性研究。
