Self‑perceived seizure precipitants among patients with epilepsy in middle‑belt Nigeria

Abstract

Aim: Patient’s perception of seizure precipitant is crucial in epilepsy management, but it is often overlooked by physicians. This may be due to neglect and underestimation of its importance. This study looked at frequency and nature of self‑perceived seizure precipitants among patients with epilepsy.
Materials and Methods: A close‑ended questionnaire‑based study. Patients with active epilepsy (≥2 attacks/year) were recruited from the neurology clinic of the University of Ilorin Teaching Hospital (UITH), Ilorin.
Result: A total of 89 patients participated in the study and of these 41 (46.1%) were males. Their median age was 30 (21-52) years and median age at seizure onset was 22 (15-46) years. The median seizure duration was five (2-14) years. More patients (46.1%) had less than secondary school education and 12 (13.5) were uneducated. Generalized epilepsy was the predominant (68.6%) seizure type. A total of 33 (37.1%) subjects had ≥4 attacks/year, 29 (32.6%) had 5-12 attacks/year, and 27 (30.3%) >12 attacks/year. A total of 16 (18%) subjects did not mention any seizure precipitant, whereas 73 (82.2%) reported at least one specific seizure precipitant; of these, 62 (85%) patients reported ≥2 precipitants. Stress (41%), inadequate sleep (27%), and head trauma (26%) were the three leading seizure precipitants mentioned. Subject’s age, sex, level of seizure control, and place of abode did not influence reported seizure precipitants. However, the more educated (>12 years education) patients significantly reported stress as seizure precipitant (P < 0.05). Most (80%) patients rightly indicated that antiepileptic drug was the best treatment for their seizure control.
Conclusion: The result of this study showed that the leading perceived seizure precipitants among epilepsy patients attending the neurology clinic of UITH were stress, inadequate sleep, head trauma, and demonic attacks and spells.

Keywords: Perceived‑seizure‑precipitant‑ epilepsy ‑Nigerian