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Advanced Neurology Seizure precipitants

ranging from 7 to 14/1,000 people. Approximately 80% of life. In view of this, we studied the seizure-provoking
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of people with epilepsy live in LMICs. Based on statistics, factors in two major referral hospitals with large patient
epilepsy accounts for 0.6% of the global burden of disease. 2 flows to generate evidence-based information for better
Active epilepsy was estimated to affect 4.4 million management of PWE.
people in Sub-Saharan Africa, while lifetime epilepsy was The findings of this study will contribute valuable data
estimated to affect 5.4 million. The prevalence of active on the prevalence of seizure-precipitating factors among
epilepsy peaks in the 20 – 29 age group at 11.5/1,000 and individuals with epilepsy. In addition, the results will
again in the 40 – 49 age group at 8.2/1,000. The lowest enhance understanding of these factors to support better
prevalence value of 3.1/1,000 is seen in the 60+ age group. self-management practices and reduce complications. This
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Based on a large-scale study conducted in Ethiopia, evidence can also inform future research, guide healthcare
epilepsy is documented as a major public health problem, providers, and assist policymakers in developing targeted
with an estimated prevalence of 5.2 – 29.5/1,000 people. 5 interventions.
The illness levies a large economic burden on global 2. Objectives
health care systems and is a major public health problem
in LMICs. In addition, because the relatives and friends The primary objective of this study was to determine the
of patients with epilepsy (PWE) also bear the burden occurrence of seizure precipitants in epileptic patients
of this condition, more than 500 million people are in two major referral hospitals with large patient flow in
indirectly affected by epilepsy. A large proportion of the Addis Ababa. Specific objectives include the following:
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overall public health burden of epilepsy is attributable to (i) to determine which precipitants are most commonly
preventable causes. The attributable fraction for perinatal reported; and (ii) to assess differences in the distribution of
causes, infections, TBI, and stroke in sum reaches nearly precipitants with regard to age group, gender, educational
25% in both LMICs and high-income countries. The level, seizure duration, number of drugs taken, seizure
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control, and types of epilepsy.
course of epilepsy may vary and is reported to display a
fluctuating course, with up to 30% of PWEs continuing to 3. Methods
have seizures, despite a range of anti-seizure medication
(ASM) treatment. 8 3.1. Study design, period, settings, and participants
Although seizures often occur spontaneously without A facility-based cross-sectional study was conducted at
an apparent inciting cause in most individuals, many two referral hospitals, namely, Tikur Anbessa Specialized
patients believe that their seizures are precipitated by Hospital (TASH) and Zewditu Memorial Hospital (ZMH).
external or internal stimuli. However, the relationship Patients were enrolled at the neurology referral clinic
between seizures and other external factors is still less from October 2018 to September 2019. TASH is one of
8,9
clear. One major concern of PWEs is the unpredictability the oldest teaching centers of Ethiopia, comprising 13
of their seizure. Yet, publications have also shown that specialty clinics, among which the neurology department
PWEs do report that their seizures were provoked by a is a pioneer in the country, providing both inpatient and
variety of endogenous or environmental precipitants. 10 outpatient services, with epilepsy being one of the top ten
diseases seen at the neurology referral clinic. According
Seizure precipitants precede the onset of an epileptic to clinical audits conducted by the neurology department
attack and are considered to be a possible explanation in 2019, the clinic sees approximately 400 – 500 patients/
for the attack. It is apparent that patients’ perception of month. On the other hand, ZMH operates a neurology
seizure precipitant is crucial in epilepsy management, follow-up clinic staffed by residents and senior faculty
though in most cases overlooked, as many of them occur members assigned by TASH’s neurology department,
in combination and receive little attention from their although ZMH reports directly to the regional health
attending physicians due to the difficulty in predicting the bureau of Addis Ababa. Both facilities have neurologists,
exact role of various seizure-provoking factors. 10 neurology residents, and trained nurses who provide care
Although the ultimate goal of treating PWEs is to for PWE.
maintain a seizure-free state, some patients may continue All PWEs aged 13 years and above who were on ASM
to experience seizures, suggesting that the broader treatment for at least 6 months were included in the study
management of epilepsy comprises more than prescribing on the assumption that having the illness for such duration
pills and counting seizures. Therefore, identifying seizure- would enable participants to be more informed of their
provoking factors contextually among patients who are experience of coping with epilepsy. Those patients who were
on ASM treatment is very crucial to improve their quality unable to provide consent and unable to communicate due

Volume 4 Issue 4 (2025) 59 doi: 10.36922/an.7679