Relevance of poor compliance for seizure control

The relationship of poor compliance to seizure control was analyzed in 101 patients with self-reported poor compliance in 2 seizure clinics. There was a close correlation of poor compliance and the coefficient of variation for phenytoin (P = 0.001), primidone (P = 0.01) and carbamazepine (P = 0.01). In comparison with self-reported compliers no difference was noted in seizure control and other clinical variables. Patients who experienced an increase of several seizures in temporal relationship with poor compliance more often reported loss of sleep (P = 0.006) and more often had frequent (more than 5 per year) seizures (P = 0.001) than non-compliers with a single seizure relapse or no change in seizure control. Exacerbation of seizures through poor compliance occurs primarily in patients with frequent seizures and through loss of sleep.