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Apparent Refractory Epilepsy; Causes and Prevalence among Sudanese Patients at the National Center of Neurological Sciences, Khartoum 2018

Abstract

Etedal Ahmed AbuElbasher Ibrahim, Khalid M Ali and FawziDafa Allah Ahmed

Background: Refractory epilepsy is a disease that requires special care from health authorities and community. This study is a trial to lighten its aspects.

Objectives: To assess the prevalence of Apparent refractory epilepsy among Sudanese patients at the National Center of Neurological Sciences (NCNC), Khartoum and to identify its causes.

Methods: This is a prospective cohort study, 100 patients of apparent refractory epilepsy were selected out of 256 patients of epilepsy according to Berg’s definition (failure of two or more drugs and occurrence of one or more seizures per month over 18 months) in the study area during the period from June 2014 to December 2018. Data was collected through pre-designed questionnaire and processed by using the Statistical Package for Social Sciences (SPSS), results was presented as tables and graphs.

Results: The prevalence of apparent refractory epilepsy was 39.1%, the mean age was 30.6 years, male to female ratio was 1.6: 1. Subtype of epilepsy showed idiopathic in 78 (78%) and secondary in 22 (22%). Within secondary epilepsy group, tumor and trauma represented 5 (22.7%) for each. Classification of epilepsy showed generalized epilepsy in 78 (78%) and partial in 22 (22%). Among generalized epilepsy 65 (83.3%) were tonic-clonic, among partial epilepsy 15 (68.2%) were partial complex. Regarding treatment, 97 (97%) of the patients used two drugs, while 3 (3%) used three drugs. In the group of patients who took two drugs combination of sodium valproate and carbamazepine were the most used (61%). Sodium valproate and carbamazepine were used by 81 (81%) for each. 55 (55%) of patients started treatment immediately, while others 45 (45%) delayed from 6 months up to 14 years. 33 (33%) of patients had family history.

Conclusion: The study concluded that, prevalence of apparent refractory epilepsy was 39.1%. The most common causes of apparent Refractory Epilepsy were uses of unsuitable combination of drugs, Family and genetic factors, wrong drug choice, and secondary etiologies of epilepsy.