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. 2023 Jun 30;13(1):13-18.
doi: 10.14581/jer.23003.

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

Abdullah Nasser Aldosari  1 , Ahmed Alghamdi  1 , Ayidh Alharthi  1 , Abdullah Albuhayri  1 , Suhaib Ghurab  1 , Mohammed Alghamdi  2 , Mufleh Aldosari  3
Affiliations

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

Abdullah Nasser Aldosari et al. J Epilepsy Res. .

Abstract

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.

Keywords: Breakthrough seizure; Children; Epilepsy; Precipitating factors; Saudi Arabia.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

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