Abstracts

Rationale: The prevalence of active epilepsy, which refers to at least one unprovoked seizure in the last five years, is 0.3-1%. However, there have only been a few reports presenting the data of triggering factors (TFs). This study was designed to assess the TFs in patients with chronic active epilepsy (PWE) in Korea. Methods: This was a prospective study of 200 consecutive PWE attending clinics for regular follow-up and taking antiepileptic drugs (AEDs) for more than six months. All PWE completed a series of questionnaires, which included clinical history of epilepsy, age, gender, comorbidity, marital and economic state, sleep quality, anxiety, depression, fatigue and stress. Also, TFs were investigated and categorized as medication, lifestyle, external factor, inner factor, or other. Results: One-hundred and forty-six (73%) PWE reported at least one TF. The frequently reported TFs were stress (83 PWE, 41.5%), fatigue (69 PWE, 34.5%), sleep deprivation (60 PWE, 30%), and missing medication (57 PWE, 28.5%). Comparing two groups based on the presence of TF, the PWE with TF group was more anxious (Generalized Anxiety Disorder 7 scale: 4.98±5.25 vs. 3.33±5.04, p=0.048) and had poorer sleep quality (Pittsburgh Sleep Quality Index, PSQI: 7.36±3.84 vs. 5.32±4.02, p=0.001) than the PWE without TF group. When comparing the two based on the presence of each groups’ TFs, PWE with sleep deprivation were younger (Age: 38.25±11.63 vs. 42.74±13.85, p=0.029) and had poorer sleep quality (8.17±4.03 vs. 6.22±3.84, p=0.001) than PWE without sleep deprivation. PWE with stress were younger (39.08±11.76 vs. 43.03±14.20, p=0.039), had poorer sleep quality (7.69±3.93 vs. 6.18±3.93, p=0.008), and were more anxious (5.68±5.27 vs. 3.73±5.08, p=0.009) and depressed (Neurological Disorders Depression Inventory for Epilepsy: 10.17±4.76 vs. 8.76±3.93, p=0.028) than PWE without stress. PWE with fatigue were younger (38.30±11.83 vs. 43.02±13.86, p=0.017) and had poorer sleep quality (7.62±3.38 vs. 6.37±4.22, p=0.035) than PWE without fatigue. Interestingly, there was no difference in clinical characteristics between PWE with and without missing medication, and it implies that missing medication per se is an important TF. Conclusions: Avoiding common TFs may have a beneficial effect on management of epilepsy. We suggest that it is worthwhile to take TFs into consideration and prevent common TFs (stress, fatigue, sleep deprivation, and missing medication) in PWE. Funding: This study was supported by Soonchunhyang University Research Fund.