Survey Of Precipitants Of Epileptic Seizure

BackgroundEpilepsy is a chronic neurological disorder characterized by recurrent seizures.Epilepsy seizures are usually spontaneous expect in reflex epilepsy,but more and more studies have found that seizures had a relation to the environment patients were surround in and the physical and psychological factors patients were with.Foreign studies have shown that more than a half of the patients with epilepsy have precipitants.Stress,sleep disorders,fatigue and other factors can often be found in patients with epilepsy after the last seizure.At present,there are more than 40 kinds of precipitants mentioned in the literature,most of which are not clear.Stress was the most common precipitants in the majority of foreign studies,but there was no relevant research at home.Precipitants often exist at the same time,such as stress often accompany by fatigue and sleep disorders,but there is an argue about the correlation.Patients with epilepsy and their families often pay attention to the notice in their treatment." why do seizures occur when they do?" has become a topic of great concern to the family members of the patients and the problems of the clinician.Therefore,our study intends to investigate whether there is a precipitants for epileptic seizures in our out-patients?What are the characteristics of distribution?Is there any relationship between the seizure precipitants?And analyze the relationship between the various precipitants and the clinical and demographic characteristics of epilepsy patients,so as to provide reference for clinicians and further study.[Objective]To investigate precipitants of epileptic seizure,and to explore the correlation between various precipitants and relationship between precipitants and clinical features of epilepsy.[Methods]Data was collected from 205 patients attending a tertiary-care epilepsy clinic of Nanjing Brain Hospital between April 2015 and April 2016.The patients with epilepsy had a clinical history of one year or more,and one seizure at least a year and one seizure at least in the latest three months.The patients who cannot complete the survey were exclude.Demographic information such as name,age and clinical information such as seizure type,frequency were collected.An enclosed questionnaire was combined with an open interview to identify seizure precipitants of patients.In order to reduce the accidental error,patients were asked respectively whether there were some precipitants during last three months and three months before.The questionnaire was designed on the basis of reference to foreign research.Statistical analysis of the collected data.We played chi square test to investigate the correlation between the common precipitants of seizures and Mann-Whitney U test or chi square test to analysis correlations between seizure precipitants and relationships between precipitants and clinical characteristics,such as age,gender,course,seizure frequency and so on were calculated.[Results]A total of 205 patients completed the questionnaire,including 118 men(57.6%)and 87 women(42.4%).Median age of the patients was 27(18,34)years,and median disease duration was 6(3,15)years.161 participants(78.5%)reported at least one precipitant.62.7%of which have the same precipitants in recent three months and before.The most common precipitants(in descending order)were as follows:emotional stress(55.3%),sleep disorder(37.9%),fatigue(26.1%),missing medication(19.9%).Nearly half of the patients(49%)thought that the precipitants of seizures has triggered more than half of seizures.There were 1-8 different precipitants for one patient,and 60.0%of patients had two or more precipitants.The common precipitants had been played chi square test by each other:emotional stress between sleep disorders(?2=6.891,P=0.009,?=0.183)and fatigue(?2=16.874,P=0.000,?=0.287),sleep disorders between fatigue(?2=4.338,P=0.037,?=0.145)showing an connection with each other.But the values were small,suggesting that the association was weak Among various factors,emotional stress induced seizures in women and men in respectively 49.4%and 39%(?2=2.223,P=0.136).Patients with idiopathic epilepsy compared with symptomatic epilepsy(?2=4.509,P=0.034)and cryptogenic epilepsy(?2=3.938,P=0.047)were more sensitive to sleep disorders.Pediatric patients were susceptible to fever(Z=3.423,P=0.001).Patients with longer history of disease were more easily affected by the weather induced seizures(Z=2.480,P=0.013).There was no relationship between total precipitants and clinical features such as age,gender,age of onset,duration,type of seizure,seizure frequency,number of drug taking and so on.[Conclusions]Seizure precipitants were found widespread.The most common precipitants were found to be emotional stress,sleep disorders,fatigue and missed medication.There existed a correlation between emotional stress and sleep disorders as well as fatigue.There was no connection between total precipitants and patient's demographic characteristics as well as clinical features.However,the type of seizure precipitants was different in patients with different demographic and clinical characteristics.Patients with idiopathic epilepsy was sensitive to sleep disorders.Children were more likely to be due to fever trigger seizures.