Preventable Etiologies of Epilepsies in Saudi Arabia: A Tertiary Care Experience

To determine the etiologies of epilepsy in a cohort of patients using the International League Against Epilepsy 2017 classification system and to determine frequencies of preventable causes and their clinical characteristics.

Epileptic patients in neurology clinics at a tertiary care hospital were prospectively recruited from June 1, 2018, to November 30, 2018. Patients were divided according to their respective etiologic categories. Traumatic brain injury, stroke, hypoxic-ischemic encephalopathy, and central nervous system infections were considered preventable etiologies.

A total of 160 patients were included in the study. Of these patients, 61 had epilepsy of unknown etiology, while among the remaining 99 patients in whom etiology could be identified, traumatic brain injury was the most frequent overall cause with 17 (17.2%) cases. Frequencies in other etiologies were genetic (idiopathic generalized epilepsy): n = 14, stroke: n = 13, hypoxic-ischemic encephalopathy: n = 13, cerebral tumors: n = 10, mesial temporal sclerosis: n = 9, cortical malformation: n = 7, and other structural pathologies: n = 5. Other rarer causes (including central nervous system infections) had less than 5 patients each. When the preventable etiologies were grouped, they formed 46 of 99 patients (46.5%) with identifiable etiology. Seizure control was mostly satisfactory in the total sample (126/160 [78.8%]), including patients with preventable etiologies, of whom 50% were on polytherapy.

Epilepsies with preventable etiologies are common in our clinics. Studies are needed in other centers to identify epilepsy etiologies and confirm our findings, which may help determine better strategies for primary prevention of epilepsy.