title: The frequency and precipitating factors for breakthrough seizures among patients with epilepsy in Uganda.
abstract: BACKGROUND
  Epilepsy is one of the major brain disorders worldwide. Breakthrough seizures carry a heavy burden of epilepsy, with increased morbidity and risk of premature mortality. Several factors have been suggested to precipitate break through seizures but these have not been studied in our setting. The study sought to determine the prevalence of breakthrough seizures, as well as precipitating factors in adults with epilepsy attending Mulago hospital.
  
  
  METHODS
  This study was conducted in Mulago Hospital, using a cross sectional study design between August and December 2009. Subjects with epilepsy and had been receiving anti-epileptics treatment for at least 6 months prior to the study were consecutively enrolled.
  
  
  RESULTS
  A total of 256 patients with epilepsy were recruited. Prevalence of breakthrough seizures among epilepsy patients attending Mulago hospital was 75.3%. Factors found to be significantly associated with breakthrough seizures were non compliance to anti-epileptic therapy (p < 0.0001); duration of treatment (p < 0.0001); infections (p < 0.044) and menses among female study participants (p < 0.0001). The level of education, sleep deprivation, alcohol and substance abuse, and flickering lights were not associated with breakthrough seizures.
  
  
  CONCLUSIONS
  Breakthrough seizures are high in Mulago National referral hospital, with drug non-compliance the commonest cause. The attending physicians need to identify precipitating factors among patients attending Mulago hospital and have them addressed appropriately during patient care.
authors.affiliation: Department of Medicine, College of Health Sciences, Makerere University, P, O, Box 7062, Kampala, Uganda. kaddumark@yahoo.co.uk.
authors.forename: Martin
authors.initials: M
authors.lastname: Kaddumukasa
authors.forename: Mark
authors.initials: M
authors.lastname: Kaddumukasa
authors.forename: Steven
authors.initials: S
authors.lastname: Matovu
authors.forename: Elly
authors.initials: E
authors.lastname: Katabira
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D015985:Precipitating Factors; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000927:Anticonvulsants