The Frequency and Precipitating Factors for Breakthrough Seizures in Children with Epilepsy

• Published in: Journal of epilepsy research Vol. 13; no. 1; pp. 13 - 18
• Main Authors: Aldosari, Abdullah Nasser, Alghamdi, Ahmed, Alharthi, Ayidh, Albuhayri, Abdullah, Ghurab, Suhaib, Alghamdi, Mohammed, Aldosari, Mufleh
• Format: Journal Article
• Language: English
• Published: Korean Epilepsy Society 30-06-2023
• Subjects: Original
• ISSN: 2233-6249; 2233-6257
• DOI: 10.14581/jer.23003

Background and Purpose: To determine the common precipitating factors for breakthrough seizures in children with epilepsy.Methods: This retrospective study reviewed the charts of children with epilepsy who were followed up in the pediatric neurology clinic of King Fahad Hospital in Al-Baha region, Saudi Arabia, between January 2015 and August 2022. Children between 1 to 14 years of age who had epilepsy, as per the International League Against Epilepsy definition and received anti-seizure medication with a seizure-free period of at least 2 months before breakthrough seizure episode, were included in the study.Results: Of the 108 children included in the study, the mean age was 6.8±1.6 years, and among them (55.5%) were male. Most parents (69.5%) were unaware of the triggering factors of seizure. The majority of patients (88%) reported at least one precipitating factor for breakthrough seizures and the most common one was systemic infection associated with fever (52.8%), and then non-compliance to medications in (34.3%) of the patients. In terms of the electroencephalogram, around 84 patients (77.8%) had abnormal electroencephalogram. Finally, monotherapy was maintained in 63.9% of patients.Conclusions: We conclude that the most common trigger for breakthrough seizure is a systemic infection associated with fever and non-compliance to anti-seizure medications. Increasing the level of awareness by different methods may help limit or even prevent seizures from occurring. Randomized controlled trials could shed light on the adjustment of anti-seizure medications temporarily by increasing the dosage or giving extra doses during the infection to avoid breakthrough seizures.