title: Epidemiology of uncontrolled epilepsy in the Al-Kharga District, New Valley, Egypt.
abstract: BACKGROUND
  Despite advances in treating epilepsy, uncontrolled epilepsy continues to be a major clinical problem. Therefore, this work aimed to study the epidemiology of uncontrolled epilepsy in Al-Kharga District, New Valley.
  
  
  METHODS
  This study was carried out in 3 stages via door-to-door screening of the total population (62,583 persons). All suspected cases of epilepsy were subjected to case ascertainment, conventional ElectroEncephaloGraphy (EEG), and the Stanford-Binet Intelligence Scale. Patients who had been receiving suitable anti-epileptic drugs (AEDs) over the previous 6 months and were having active seizures were considered uncontrolled, according to Ohtsuka et al.(23) The patients underwent serum AED level estimation, video EEG monitoring, and brain MRIs. Fifty age- and gender-matched patients with controlled epilepsy were chosen for statistical analysis and compared with true intractable patients.
  
  
  RESULTS
  A total of 437 patients with epilepsy were identified, 30.7% of whom (n=134/437) were uncontrolled, with a prevalence of 2.1/1000. A total of 52.2% of uncontrolled patients (n=70/134) were inappropriately treated, while 47.8% (n=64/134) were compliant with appropriate treatments. Video monitoring EEG of compliant uncontrolled patients demonstrated that 78.1% patients (n=50/64) had definite epilepsy, while 21.9% (n=14/64) had psychogenic non-epileptic seizures (PNES). A logistic regression analysis revealed that status epilepticus, focal seizures, and mixed seizure types were risk factors for intractability.
authors.affiliation: Department of Neurology & Psychiatry, Assiut University, Egypt. wafmaf2002@yahoo.com
authors.forename: Wafaa M A
authors.initials: WM
authors.lastname: Farghaly
authors.forename: Hamdy N
authors.initials: HN
authors.lastname: El-Tallawy
authors.forename: Tarek A
authors.initials: TA
authors.lastname: Rageh
authors.forename: Eman M
authors.initials: EM
authors.lastname: Mohamed
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Metwally
authors.forename: Ghaydaa A
authors.initials: GA
authors.lastname: Shehata
authors.forename: Reda
authors.initials: R
authors.lastname: Badry
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Abd-Elhamed
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004534:Egypt / Q000453:epidemiology; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D012640:Seizures / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology
keywords: Epidemiology; Intractable epilepsy; Predictors; Psychogenic non-epileptic seizures