Details

Autor(en) / Beteiligte

• Salas-Puig, Xavier
• Iniesta, Marc
• Abraira, Laura
• Puig, Josep

Titel

Accidental injuries in patients with generalized tonic–clonic seizures. A multicenter, observational, cross-sectional study (QUIN-GTC study)

Ist Teil von

• Epilepsy & behavior, 2019-03, Vol.92, p.135-139

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2019

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• Patients with epilepsy have a higher risk of accidental injuries. The aim of this study was to determine the incidence of accidental injuries and quality of life in patients with epilepsy and generalized tonic–clonic seizures and their association with patient-related factors. This is an observational, cross-sectional, multicenter study of patients with epilepsy and primary generalized tonic–clonic seizures and/or focal to bilateral tonic–clonic seizures in the routine clinical practice of epilepsy clinics. In a single visit, demographic and clinical data and information on the type and severity of injuries were collected, and patients' quality of life was evaluated with the QOLIE-10 questionnaire. In total, 406 patients with a median age of 41.1 years (range: 13–87) were included; 47.5% were women. Age at onset of tonic–clonic seizures was 25.4 (range: 0–83) years. Epileptic seizures were primary tonic–clonic (67.2%), focal to bilateral tonic–clonic (32.8%), focal with impairment of awareness (23.6%), focal without impairment of awareness (13.5%), absences (14.8%), and myoclonic (9.6%). Etiology was symptomatic or with unknown etiology focal (42.9%), genetic generalized (36.9%), symptomatic or with unknown etiology generalized (18.0%), and others (2.2%). The number of generalized tonic–clonic seizures in the last 12 months was as follows: 1 (41.9%), 2–5 (42.4%), and >5 (15.8%). Antiepileptic treatment at the time of the visit was monotherapy in 44.1% of the patients. The most commonly used drugs were levetiracetam (45.1%), valproate (20.7%), lamotrigine (20.0%), and perampanel (18.7%). In total, 59.6% of the patients had experienced at least one accidental injury associated with tonic–clonic seizures in the last 12 months, the most common being head injuries (35.5%), dental injuries (4.9%), burns (4.9%), and fractures (3.9%). A total of 25.1% had suffered at least one serious injury. The multiple logistic regression model showed that the factors associated with suffering an injury were the following: etiology (symptomatic or with unknown etiology focal and genetic generalized vs. symptomatic or with unknown etiology generalized, p = 0.0008 and p = 0.0077, respectively), number of seizures in the last year (2–5 vs. 1, p = 0.0115; >5 vs. 1, p = 0.0004), and psychiatric comorbidities (p = 0.0151). Patients with injuries had a worse quality of life than patients without injuries, according to the overall QOLIE-10 score (p = 0.0003). More than half of the patients had accidental injuries related with seizures. Symptomatic or with unknown etiology focal epilepsy and genetic generalized epilepsy, >1 seizure in the last year, and concomitant psychiatric disease are the risk factors associated with accidental injuries in patients with tonic–clonic seizures, with the consequent worsening of quality of life. •Epileptic seizures are associated with a higher risk of accidental injuries.•Observational study in patients with epilepsy with generalized tonic–clonic seizures•A total of 59.6% of the patients suffered a seizure-related injury in the last 12 months.•Risk factors: symptomatic or with unknown etiology focal, genetic generalized, >1 seizure, psychiatric comorbidity.•Patients with injuries had a poorer quality of life (QOLIE-10 score).