Abstracts

Rationale: Higher Body Mass Index (BMI) is reported in people with epilepsy (PWE). In Jamaica, a rapid demographic shift towards overweight is occurring, including those of lesser socio-economic means. Many anti-epileptic drugs (AEDs) are known to affect the BMI, with weight gain being a frequent complication of longstanding treatment particularly with the older less expensive AEDs. We assessed BMIs of PWE at the Neurology clinic of the Kingston Public Hospital, located in an underprivileged area of inner-city Kingston. Methods: 60 consecutive patients were examined and BMI recorded as kg/ m2. Information on level of physical activity was obtained and additional data on occupation, seizure control and AEDs were retrieved from their clinic files & analyzed using SPSS software. Results: All PWE in this study had localization-related epilepsy. 58% were female. Mean age was 35.8 years. 65% were unemployed. 92% reported low physical activity, 28.3% were sedentary. 51.6% had seizure-onset between 5-20 years of age and 80% had epilepsy >5 years. 85% reported good AED compliance with 66.7% on monotherapy. Only 21.7% reported seizure freedom in the preceding 6 months. No AED was associated with change in BMI. Mean BMI was 25.8 with 29/60 (48.3%) overweight or obese. Overall, BMIs were similar to national averages except in females <30 years old (n=13, BMI 22.3 vs 26.5, p <0.01). Unemployment also correlated with lower BMI (employed vs unemployed males 25.7 vs 23.8, females 30.2 vs 25.1). Epilepsy duration >5 years correlated with reduced BMI in males (24.0 vs 28.9) and females (25.9 vs 31.6). Conclusions: No AED, including valproate, was associated with a significant increase in BMI compared to Jamaican national averages. BMIs overall were similar to national data, but significantly reduced in women <30 years old. It appears that, in this underprivileged population, epilepsy, while not causing overt under-nutrition as in some developing countries, may have a significant impact on BMI, particularly in the vulnerable sub-population of young women of child-bearing age.