Authors :
Presenting Author: Salma Bashayreh, MD – Jordan University of Science and Technology
Mohammed Baker, M.B.B.S – Jordan University of Science and Technology
Ahmed Yassin, MD – Jordan University of Science and Technology
Melaad Yousef, M.B.B.S – Jordan University of Science and Technology
Wasan Alhdairis, M.B.B.S – Jordan University of Science and Technology
Husam Alqtami, M.B.B.S – Jordan University of Science and Technology
Dua'a Ebnian, M.B.B.S – Jordan University of Science and Technology
Lama Hatamleh, M.B.B.S – Jordan University of Science and Technology
Hanan Mehdawi, M.B.B.S – Jordan University of Science and Technology
khalid El-Salem, MD – Jordan University of Science and Technology
Mohammed Albarbarawi, MD – Jordan University of Science and Technology
Mohammad Zubi, MD – Jordan University of Science and Technology
Khalid Kheirallah, MD – Jordan University of Science and Technology
Rationale:
Background: Acute symptomatic seizures (AsyS) are seizures occurring at the time of a systemic insult or in close temporal association with a documented brain insult. Provoking etiologies of AsyS and risk of seizure recurrence among different etiologies vary. This mandates a clear identification of the most common etiologies of AsyS and risk of seizure recurrence in a specific geographical area in order to improve the early recognition of such underlying causes and the comprehensive medical response to the seizures and their etiologies.
Purpose: To identify the most common etiologies of AsyS and the seizure recurrence risk for adult patients admitted to a tertiary hospital in Northern Jordan.
Methods:
This is a retrospective cohort study done by reviewing the electronic medical records of adult patients who presented to a tertiary hospital in Northern Jordan with AsyS between 2021 and 2023. We excluded patients younger than 16 years and those with diagnosis of epilepsy at the time of presentation.
Results:
110 patients were included (51.8% females). 75 (68.2%) patients had a previous history of provoked seizures. 87 (79.1%) patients suffered a structural etiology, which included the following, in descending order: Ischemic insult (69%), hemorrhagic insult (16%), cerebral venous thrombosis (5.7%), tumor-related (3.4%), head trauma (1.1%), others (4%). Non-structural etiologies constituted 20.9% (n=23), as follows: Metabolic (52%), infectious (35%), hypoxic insult (4.3%), others (8.7%). Out of 72 patients monitored for 30 days, 12 (16.7%) patients had seizure recurrence. In contrast, among 64 patients monitored for 90 days, only 3 (4.7%) patients experienced seizure recurrence. 30-day recurrence rate for structural etiologies was higher than nonstructural etiologies (19.3% versus 6.7%). Also, 90-day recurrence rate was higher in patients with structural etiologies (6.0% versus 0.0%).Conclusions:
Around 80% of patients with AsyS have a structural etiology, the most common of which is ischemic insults, compared with 20% of cases attributed to non-structural etiologies, with metabolic alterations being the most common. Seizure recurrence occurred most frequently in the first month following the AsyS (17%),and in patients with structural etiologies. Therefore, clinicians should maintain high vigilance for seizure recurrence in patients with structural etiologies during the first month following AsyS.
Funding: None