Prevalence and risk factors of functional seizures among adult Sudanese patients with epilepsy, a cross-sectional clinic-based study.

Abstract

BackgroundEpilepsy can be associated with functional seizures. Our main aim is to assess functional seizures' prevalence and risk factors among adult Sudanese patients with epilepsy.MethodsThis cross-sectional clinic-based study was conducted from January to February 2021 at Daoud Charity Clinic in Omdurman city, Sudan. Ninety-nine adult Sudanese patients with epilepsy were included. Data were collected using a validated interview-based semi-structured questionnaire. A senior consultant neurologist and a consultant psychiatrist diagnosed the functional seizures based on full clinical history and investigations. The diagnosis was performed according to International League against epilepsy (ILAE) classification.ResultsThis study included 99 patients with epilepsy, 57% were females, 79% reside in Khartoum state, and 32% reached secondary school. The main types of epilepsy were generalized tonic-clonic (68%), followed by focal seizures with impaired awareness (11%). The majority of the patients have been diagnosed with epilepsy for over three years (65%). Comorbid epilepsy and functional seizures were found in 29% of the patients, with a significantly higher prevalence in patients with social problems and depression (p = 0.005 and p < 0.01, respectively). Patients with depression had a 14 times higher risk of functional seizures than those without depression, 95% CI [3.8, 52.3].ConclusionA remarkably high prevalence of functional seizures was found among adult patients with epilepsy. Patients suffering from social problems and/or depression and poor economic status had a higher tendency to develop functional seizures, especially after two to three years of treatment and above.