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Seizure precipitants in children with intractable epilepsy
Peng-Cheng Fang1, Yung-Jung Chen, Inn-Chi Lee
1Department of Pediatrics, Sin-Lau Christian Hospital, Tainan, Taiwan.
Purpose:
To investigate the seizure precipitants in children with intractable epilepsy, and to determine any distinctive clinical features contributing to seizures in these patients.
Methods:
A questionnaire and seizure diary prepared by the parents of the patients. Demographic and seizure data were reviewed.
Results:
Of 120 patients with intractable epilepsy, 74 (62%) had one (n=43), two (n=23), or three seizure precipitants (n=8). The three most common precipitants were illness or fever (32%), sleep deprivation (13%), and menstruation (10%). Of these precipitants, inducing factors (endogenous origin) were more common than triggering factors (exogenous origin): 73% versus 27%, respectively. Three distinctive clinical features - neurological abnormalities (P=0.01), status epilepticus (P=0.017), and abnormal neuroimaging (P=0.007) - were significantly more common in patients with than in patients without precipitants.
Conclusions:
Prompt recognition and management of seizure precipitants has practical implications for treating patients with refractory epilepsy. Such patients can be counseled to avoid specific precipitants.
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