Abstracts

Rationale: To report our experience in the Middle East region of how often patients with Idiopathic generalized epilepsy (IGE) are placed on inappropriate antiepileptic drugs (AEDs) before being seen at an epilepsy referral clinic. Methods: We retrospectively reviewed the EEG reports of patients at our EEG lab from the year 2004-2009. Patients with a confirmed diagnosis of IGE based on EEG criteria were identified. We reviewed their demographic data, work up for epilepsy, seizure types, and seizure frequency prior to evaluation at an epilepsy clinic. The primary objective of this study was to study the percentage of patients with IGE receiving inappropriate AEDs. The secondary objective was to determine the percentage change in seizure response rate after evaluation at the epilepsy clinic and initiating appropriate AEDs if indicated. Results: 109 patients were identified, ages 12-56, mean 26, with seizures duration of 1 month to 30 years, mean 10 years. When initially seen, 32.11 % were on broad-spectrum (adequate) AED only, 25.68 % on ill-advised AED only and 15.59 % on various combinations. Of the patients who were receiving ill-advised AED, 28.44 % were seizure-free and 39.44 % were doing poorly. These were converted to broad-spectrum AED; of which, 50% became better controlled. In addition, 24.8% of patients were previously on no AEDs prior to the clinic visit and once placed on adequate AEDs were controlled. Conclusions: Our findings confirm the previous views that a poor choice of AED is still the main cause of IGEs that are seemingly difficult to control and indicate the importance of establishing specialized epilepsy clinics to evaluate these patients and make the appropriate changes. In our region, the inappropriateness of some AEDs for IGE is either not well known or neglected.