Abstracts

Rationale: Consanguineous marriage is a common marital habit observed in Saudi Arabia, and in particular, in the southern region, where it ranges between 34.5 to 86.6 % , and the effect of this on the increased incidence of some hereditary and congenital diseases is known ( El Hazmi et al;1995), but it is not known if this social habit has an impact on epilepsy. The aim of this study is to assess epilepsy risk factors in new cases of epilepsy, and whether consanguinity has any effect through the presence or absence of family history of epilepsy in these cases.Methods: This is a six months prospective study conducted at Aseer central hospital, Abha , Saudi Arabia from January 2010 to June 2010. All patients were evaluated at the outpatient neurology clinic, with electroencephalogram (EEG) recording, and high resolution 1.5 T magnetic resonance imaging (MRI). Data were collected to evaluate risk factors, epilepsy classifications, EEG patterns, and MRI findings.Results: 48 patients were included with the mean age of 28 years (range; 13-72 years), mean age of disease onset was 27 years (range; 6-72 years). There were 27 men (56%). The average of 3.5 seizures were documented before seeking medical attention, over 2.5 years from the first seizure (range; 0-12). Seizures were classified into: 1) focal (65%); 2) generalized (15%); and 3) unclassified (20%) (Figure 1). Magnetic resonance imaging (MRI) was abnormal in 33%, EEG was abnormal in 42%. Family history of epilepsy was documented in 34%, head trauma in 11%, febrile convulsion in 6%, vascular lesion in 6%, 8% had other risk factors (CNS infection, cortical dysplasia, metabolic derangement), and 38% had no identified risks (Figure 2). Presence of family history of epilepsy was significantly associated with younger age group (p=0.003), younger age of epilepsy onset (p =0.007), and the EEG findings (p=0.001).Conclusions: Although focal epilepsy was the most recognized epilepsy type, family history of epilepsy was the most identified risk factor , which was associated with a younger age at presentation and at the disease onset. This was also associated with the EEG findings, but no differences were identified regarding the gender or the MRI findings. The higher than expected risk of family history is likely related to the consanguinity commonly encountered in the region. Further studies are required, with a larger sample, to assess this association, and probably the genetic background of this risk.