Neurosciences (Riyadh, Saudi Arabia) [Neurosciences (Riyadh)] 2018 Jul; Vol. 23 (3), pp. 185-193.
Anticonvulsants administration dosage, Anticonvulsants adverse effects, Disease Management, Epilepsy drug therapy, Epilepsy psychology, Female, Humans, Pregnancy, Pregnancy Complications drug therapy, Saudi Arabia, Anticonvulsants therapeutic use, Epilepsy diagnosis, and Pregnancy Complications diagnosis
In the context of local culture and misconceptions regarding epilepsy, Saudi practitioners need a careful management plan for women with epilepsy that satisfies all the patients` needs and ensures their spouses` understanding. Such a management strategy needs to incorporate careful selection and monitoring of anti-epileptic drugs and regular counseling of patients. Female epileptic patients in the reproductive age group, no matter whether they are pregnant or not, should be managed by safest drugs from the earliest with folic acid supplementation along with adequate pre-marriage/conception counseling. All antiepileptic drugs are potentially teratogenic. However, valproic acid, phenytoin, phenobarbitone, and topiramate are least favored for use. Monotherapy is preferred over polytherapy, and the least possible dose should be used. During pregnancy, many epileptic women may need monthly drug level monitoring and dose readjustments. Normal vaginal delivery is safe in epileptic women. Post-partum follow-up with anti-epileptic drug titration may be required.
Shahid R, Nazish S, Zafar A, Aljafaari D, Alabdali M, Ishaque N, Alzahrani BA, and Alkhamis FA
Neurosciences (Riyadh, Saudi Arabia) [Neurosciences (Riyadh)] 2018 Jul; Vol. 23 (3), pp. 223-226.
Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Saudi Arabia, Epilepsy epidemiology, and Tertiary Care Centers statistics numerical data
Objective: To identify the types of seizures and describe the clinical features, EEG and radiological findings among patients with epilepsy. Methods: In this retrospective epidemiological study, we analyzed the medical records of the patients with the diagnosis of epilepsy during the study period (January 1st 2016- December 2016) RESULTS: The study included 184 patients, 91 (49.5%) were males and 93 (50.5%) females. Age ranged between 12 and 85 years (mean 35.4+/-19.5 SD years). Most of the patients 150 (82%) had Generalized tonic clonic seizures followed by focal onset in 27 (14%) of the patients. Main EEG abnormality was focal to bilateral was recorded in 53 (41%), idiopathic/ cryptogenic epilepsy was diagnosed in 61% of the patients. The most common abnormalities on brain imaging were temporal/hippocampal atrophy/stroke. The most common cause of symptomatic epilepsy was stroke found in 20(11%) followed by post infectious epilepsy and head trauma. Conclusion: Seizure types, EEG characteristics and etiologies of symptomatic epilepsy in our cohort of patients are in accordance with the current literature. Slight discrepancy observed in gender distribution and etiologies for symptomatic epilepsy compared with other studies from Saudi Arabia need to be studied further by prospective and population base studies.