Drug treatment-related factors of inadequate seizure control

Abstract To optimize seizure control it is important to identify modifiable factors. We conducted a case–control study to explore to what extent drug treatment-related factors are associated with seizures. Eighty-six patients with epilepsy were evaluated: 45 cases (recently experienced a seizure) an...

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Bibliographic Details
Published in:Epilepsy & behavior 2008-10, Vol.13 (3), p.545-548
Main Authors: Handoko, Kim B, Zwart-van Rijkom, Jeannette E.F, Visee, Huib F, Hermens, Walter A.J.J, Hekster, Yechiel A, Egberts, Toine C.G
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anticonvulsants - blood
Anticonvulsants - therapeutic use
Antiepileptic drugs
Case-Control Studies
Compliance
Compliance - physiology
Confidence Intervals
Epilepsy
Female
Humans
Logistic Models
Male
Middle Aged
Neurology
Odds Ratio
Retrospective Studies
Risk Factors
Seizure control
Seizures - blood
Seizures - drug therapy
Seizures - psychology
Therapeutic drug monitoring
Treatment Outcome
Young Adult
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Summary:Abstract To optimize seizure control it is important to identify modifiable factors. We conducted a case–control study to explore to what extent drug treatment-related factors are associated with seizures. Eighty-six patients with epilepsy were evaluated: 45 cases (recently experienced a seizure) and 41 controls (seizure-free for at least 2 months). There was a significant association between low AED serum concentration and seizures (odds ratio (OR) = 8.9, 95% confidence interval (CI) = 1.7–47.8), compliance was not associated with seizures (OR = 0.9, 95% CI = 0.2–4.0), and changes in medication (mainly non-AEDs) were more frequently observed in the case group than in the control group (OR = 4.1, 95% CI = 0.9–18.3). These findings indicate that patients with low AED serum levels have a nine times higher risk of seizures compared with patients with therapeutic AED levels and that changes in medication regimens in patients with epilepsy should be made with care.
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2008.04.007