Survey of precipitants of epileptic seizure

Abstract

Objective To investigate precipitants of epileptic seizure, and to explore the correlation between various precipitants and relationship between precipitants and clinical features of epilepsy. Methods Data were collected from 154 patients attending a tertiary-care epilepsy clinic of Nanjing Brain Hospital between April 2015 and April 2016. The patients with epilepsy were older than 16 years, had a clinical history of one year or more, and one seizure at least a year and one seizure at least in the latest three months. An enclosed questionnaire was combined with open interview to identify and characterize seizure precipitants and clinical characteristics of patients. Patients were asked respectively whether there were some precipitants three months before and during last three months. Correlation between seizure precipitants and relationship between precipitants and clinical characteristics, such as age, gender, course, seizure frequency and so on, were calculated. Results A total of 125 (81.2%) participants reported at least one precipitant. Common precipitants (in descending order) were as follows: emotional stress (56.0%), sleep disorder (38.4%), fatigue (27.2%), missed medication (20.0%). There were one to six different precipitants for one patient, and 60.8% of patients had two or more precipitants. There was a correlation between emotional stress and sleep disorders as well as fatigue (χ2=4.665, 8.668; P<0.05). Patients with idiopathic epilepsy were more sensitive to sleep disorders. There was no relationship between total precipitants and clinical features such as age, gender, age of onset, duration, type of seizure, seizure frequency, number of drug taking and so on. Conclusions Seizure precipitants were found widespread. The most common precipitants were found to be emotional stress, sleep disorders, fatigue and missed medication. There existed a correlation between emotional stress and sleep disorders as well as fatigue. There was no connection between total precipitants and patient′s demographic characteristics as well as clinical features. However, the type of seizure precipitants was different in patients with different demographic and clinical characteristics. Key words: Epilepsy; Stress; Psychological; Sleep disorder; Fatigue