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Advanced Neurology Seizure precipitants

Table 2. Clinical characteristics of respondents but 2.4% of females (p=0.025). Fifteen out of 83 women
(18%) in the study reported menstruation as a seizure
Variables Mean±SD/Number (%)
precipitant (Figure 2).
Age at seizure onset (years) 21.4±12.6
The PWEs on polytherapy frequently reported missing
Age at diagnosis (years) 22.2±80.1 ASM dose as a precipitant compared to patients on
Duration of epilepsy (years) 9.9±13.1 monotherapy, though the difference was not significant
Distribution of PWEs by duration of epilepsy (p=0.192). Table 3 indicates the distribution of seizure
0.5 – 9 years 115 (62.5) precipitants among respondents. Patients who had seizures
10 – 19 years 43 (23.4) in the past 2 years were more likely to report precipitating
>20 years 20 (10.9) factors (96.2 %) than patients with no seizures in the past
Seizure episodes in the past 2 years 2 years (81.5%), with excessive sunlight exposure being
Yes 157 (85.3) particularly common. This difference was statistically
No 27 (14.7) significant (p=0.03).
PWEs who had history of febrile seizure 28 (15.2) Table 4 displays the distribution of seizure precipitants
PWEs with a family history of epilepsy 22 (12.0) across different age categories. Excessive sunlight exposure,
PWEs who took monotherapy 108 (58.7) fatigue, and auditory stimulus had a significant association
with the age categories in inducing seizure, while emotional
PWEs who took polytherapy 76 (41.3) stress, missing anti-epileptic dose, and sleep deprivation
PWEs with a history of status epilepticus 54 (29.3) were observed to have no association.
PWEs with generalized types of epilepsy 118 (64.1) About a quarter of the respondents (22.8%) claimed
PWEs with focal awareness (simple partial) 23 (12.5)
to have 100% of their seizures related to some precipitant
PWEs with focal impaired awareness (complex) 22 (12) factors. Of these, 60.3% believe that their seizures
PWEs with focal to bilateral tonic–clonic 11 (6) were precipitated by the aforementioned factors. One
seizure hundred and thirty-two of them (71.7%) were able to
PWEs with mixed seizures 5 (2.7) decrease the frequency of their seizure by avoiding the
PWEs with not classified 4 (2.2) precipitating factors. A statistically significant correlation
PWEs with unknown 1 (0.5) was found between precipitating factors such as stress,
PWEs who took phenobarbital 59 (32) sleep deprivation, fatigue, and missing anti-epileptic dose
PWEs who took phenytoin 44 (24) (Table 5).
PWEs who took valproic acid 39 (21) 5. Discussion
PWEs who took carbamazepine 33 (18)
PWEs who took lamotrigine 9 (5) The present study assessed the precipitants of seizure from
two major referral hospitals in the capital city of Ethiopia
Abbreviations: PWEs: Patients with epilepsy; SD: Standard deviation.
with a large flow of PWEs. In terms of age, our findings are
The three leading seizure precipitants were stress (in comparable with previous studies. 10,13,14 The most common
129 [70.1%]), missing anti-epileptic dose (in 105 [57.1%]), type of epilepsy in this study was generalized tonic-clonic
and inadequate sleep (in 59 [32.1%]). Other less common (GTC) seizure type (64.5%), which is closer to findings
15
16
precipitants mentioned were pregnancy (3%), cigarette reported in India (61%), Turkey (52%), and Sudan
1
14
smoking (3%), and sexual intercourse (1%). (61%) but lower than those in Egypt (77.1%), Middle Belt
of Nigeria (79.1%), and local study conducted in Zeway,
10
Slightly more females (96.4%) than males (92.1%) Ethiopia (82%). These differences are probably attributed
17
reported at least one PF, though the difference was to disparities in settings.
not statistically significant (p=0.22). Likewise, the
percentage of females who reported emotional stress as The mean number of seizure triggers is about 3 – 4
a precipitating factor was also more than that of males (3.97) per subject, and every subject was able to report
(77.1% vs. 64.4%), and the differences noted were not between one to a maximum of 13 precipitating factors
statistically significant (p=0.6). More females (37.3%) that precipitated their seizures in this study; this finding
than males (27.7%) indicated inadequate sleep as seizure is in agreement with some previous studies performed
precipitants, but the difference was not statistically elsewhere. For instance, a study conducted in Brazil
significant (p=0.164). On comparing male and female showed that PWEs often cited multiple factors, up to 9
patients, alcohol precipitated seizure in 10.9% of males (mean 2.9 ± 1.7); Indian PWEs cited a maximum of 10

Volume 4 Issue 4 (2025) 61 doi: 10.36922/an.7679