(308) Evaluation Epilepsy Patterns and Treatment Approaches: Findings from a Neurological Tertiary Care Hospital

Background: Epilepsy, a neurological disorder characterized by recurrent seizures, carries significant long-term consequences. A comprehensive classification of epilepsy provides valuable insights into the diverse manifestations of the condition within specific populations or geographic regions.

Objectives: To determine the epilepsy patterns and treatment approaches at a neurological tertiary care hospital.

Methods: A cross-sectional observational study was conducted at a neurological tertiary care hospital in India between October 2022 and March 2024. Patients who were diagnosed with epilepsy as per diagnostics protocol, regardless of age or gender, were included. The information gathered included a demographic profile, clinical history, electroencephalogram (EEG), neuroimaging, and treatment. Based on the International League Against Epilepsy (2017) classification of epilepsies, patients were categorized according to their types of seizures and epilepsy. In addition, patients were classified based on specific aetiologies, syndromes, and comorbidities. Categorical data were expressed in terms of frequency and percentage.

Results: A total of 842 patients were included, with the majority being young adults (275, 32.7%) and predominantly male (464, 55.1%). The onset of epilepsy in adults aged 19 to 35 years was observed in 272 (32.3%) patients. An initial abnormal EEG was detected in 697 (82.8%) patients, with 396 (47.0%) diagnosed with focal epilepsy and 257 (30.5%) with generalized epilepsy. Reflex epilepsy syndrome was identified in 36 (45.5%) patients, and childhood epilepsy syndrome was found in 22 (25.3%) patients. Structural etiology, indicated by abnormal neuroimaging findings, was present in 219 (26.0%) patients, with gliosis being the most common finding. Post-traumatic epilepsy was reported in 57 (6.8%) patients, and post-stroke epilepsy in the older age group was observed in 50 (5.9%) patients. Developmental milestones were delayed in 82 (9.7%) patients. A family history of epilepsy was reported in 29 (3.4%) patients, with comorbidities such as neuropsychiatric abnormalities in 63 (7.4%), cognitive deficits in 60 (7.0%), and motor deficits in 60 (7.0%) patients. Treatment included monotherapy in 505 (60.0%) patients and polytherapy in the remaining 40.0%. Additionally, 8 patients had pharmacological comorbidities, and 75 (8.9%) patients demonstrated poor medication compliance.

Conclusion: The study highlights the predominance of young adults and the higher prevalence of focal epilepsy. Structural brain abnormalities, particularly gliosis, along with comorbidities, developmental delays, and poor medication compliance, underscore the need for comprehensive and individualized treatment strategies to improve patient outcomes.

Keyword: Epilepsy; Focal Epilepsy; Generalized epilepsy, Treatment