Seizures and Therapy in Adolescents with Uncomplicated Active Epilepsy.
Abstract number :
2.058
Submission category :
Year :
2000
Submission ID :
2440
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Lena K A Raty, Bodil Wilde-Larsson, Birgitta A Soderfeldt, Div for Health and Care, Karlstad Univ, Karlstad, Sweden; Faculty of Health Science, Linkoping Univ, Linkoping, Sweden.
RATIONALE: There are few studies describing seizures and therapy in adolescents with uncomplicated epilepsy, i.e. without other handicaps. This study aimed to describe seizures and therapy among Swedish adolescents, 13-22, with active but uncomplicated epilepsy. METHODS: All adolescents, 13-22, fulfilling criteria (n=194) registered in four Swedish hospitals, answered questionnaries (158/194) on their seizures and therapy. Data were also collected from the patients medical journals. RESULTS: Over 70% have had epilepsy three years or more. Dominating seizure-types were generalised seizures (39.2%) and partial complex seizures (24.1%). Unspecified classification was found in 24.7% of the patients. Eighty-eight percent were on antiepileptic drugs (AED) but almost 40% had seizures in spite of AED treatment. Most common AEDs were valproate (VPA) (37.3%) and carbamazepine (CBZ) (25.9%). In 8.9% of the patients new antiepileptic drugs were used as monotherapy. Combination of two AEDs was found in 13.9% of the cases. Side effects of AED were experienced by 61.2%. Most common were tiredness(47.5%), concentration difficulties (21.6%) and headache (14.4%). These side effects did not differ between monotherapy with traditional or new AEDs or polytherapy. Patients treated with a combination of two AEDs experienced however significantly (p<0.001) more side effects as a whole. Polytherapy also meant higher seizure frequency (p<0.024). Choice of new AEDs over traditional had no connection to a certain type of epilepsy. CONCLUSIONS: Our results suggest that as much as 40% of Swedish adolescents with uncomplicated epilepsy continued to have seizures despite drug treatment and contact with specialised neurology/child neurology centres. Exact diagnosis is lacking for about one-fourth. Traditional AEDs strongly dominated treatment, but the fact that so many of the patients still had seizures can give a hint that newly marketed AEDs are underused in this group. Side effects of AEDs were very common and can also implicate that treatment is not optimal for the group of patients studied.