Prevalence and risk factors of seizure clusters in adult patients with epilepsy

Baibing Chen, Hyunmi Choi, Lawrence J. Hirsch, Austen Katz, Alexander Legge, Rebecca A. Wong, Alfred Jiang, Kenneth Kato, Richard Buchsbaum, Kamil Detyniecki

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Purpose In the current study, we explored the prevalence of physician-confirmed seizure clusters. We also investigated potential clinical factors associated with the occurrence of seizure clusters overall and by epilepsy type. Methods We reviewed medical records of 4116 adult (≥16 years old) outpatients with epilepsy at our centers for documentation of seizure clusters. Variables including patient demographics, epilepsy details, medical and psychiatric history, AED history, and epilepsy risk factors were then tested against history of seizure clusters. Patients were then divided into focal epilepsy, idiopathic generalized epilepsy (IGE), or symptomatic generalized epilepsy (SGE), and the same analysis was run. Results Overall, seizure clusters were independently associated with earlier age of seizure onset, symptomatic generalized epilepsy (SGE), central nervous system (CNS) infection, cortical dysplasia, status epilepticus, absence of 1-year seizure freedom, and having failed 2 or more AEDs (P < 0.0026). Patients with SGE (27.1%) were more likely to develop seizure clusters than patients with focal epilepsy (16.3%) and IGE (7.4%; all P < 0.001). Analysis by epilepsy type showed that absence of 1-year seizure freedom since starting treatment at one of our centers was associated with seizure clustering in patients across all 3 epilepsy types. In patients with SGE, clusters were associated with perinatal/congenital brain injury. In patients with focal epilepsy, clusters were associated with younger age of seizure onset, complex partial seizures, cortical dysplasia, status epilepticus, CNS infection, and having failed 2 or more AEDs. In patients with IGE, clusters were associated with presence of an aura. Only 43.5% of patients with seizure clusters were prescribed rescue medications. Conclusion Patients with intractable epilepsy are at a higher risk of developing seizure clusters. Factors such as having SGE, CNS infection, cortical dysplasia, status epilepticus or an early seizure onset, can also independently increase one's chance of having seizure clusters.

Original languageEnglish (US)
Pages (from-to)98-102
Number of pages5
JournalEpilepsy Research
Volume133
DOIs
StatePublished - Jul 1 2017
Externally publishedYes

Keywords

  • Benzodiazepine
  • Intractable epilepsy
  • Lobe localization
  • Predictors
  • Risk factors
  • Seizure freedom
  • Status epilepticus
  • Symptomatic generalized epilepsy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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