Abstracts

Rationale: We recently characterized the features of epilepsy in Qatar, a small country on the eastern coast of the Arabian Peninsula. We are expanding our analysis to investigate factors correlating with outcome. Predictors of remission in persons with epilepsy remain controversial in the international literature and have not been previously studied in this region. Methods: A database was created in 2014-2015 to summarize information collected on patients with epilepsy treated at the national health system (HMC) adult neurology clinic. We identified the demographic and disease related variables for all patients and compared them in relation to seizure outcome. Results: 463 patients, with a mean age of 35, were studied. On the last documented clinic visit, 54% of subjects were seizure free for at least six months. With the univariate analysis, factors correlating with the lack of seizure freedom included history of adverse perinatal events (p=0.005), presence of complex partial seizures (p=0.001), focal epileptiform discharges in the EEG (p=0.03), and multiple drug trials (p < 0.001). Presence of an identifiable cause did not influence the outcome, but amongst symptomatic epilepsy, neurocysticercosis was accompanied by a favorable seizure outcome (p=0.04). As for epilepsy syndromes, juvenile myoclonic epilepsy stood out with a 70% seizure freedom rate (p=0.02). Age at seizure onset, psychomotor development, antecedent febrile seizures, family history and neurological deficits did not correlate with the outcome. On further multivariate analysis, only the occurrence of complex partial seizures stood out as a predictor of an unfavorable seizure outcome (p=0.05), and a diagnosis of juvenile myoclonic epilepsy maintained its higher correlation with seizure freedom (p=0.02). Conclusions: Our study suggests an overall lower rate of seizure freedom in partial epilepsy if complex partial seizures are present, regardless of the focus. Symptomatic cases do not differ regarding outcome compared to epilepsy without identifiable etiology, but neurocysticercosis may predict a favorable seizure outcome within symptomatic epilepsy. Not surprisingly, juvenile myoclonic epilepsy stood out with a favorable outcome compared to other adult epilepsy syndromes. Funding: QNRF