Abstracts

Rationale: Fatigue is commonly encountered in epilepsy patients and it is thought to be more prevalent in epilepsy in comparison to the general population. The relationship between fatigue and epilepsy is complex as fatigue is a known trigger for seizures and it can also result from seizures either in interictal or post ictal state which can last for days causing functional impairment. Therefore, knowing the risk factors for fatigue and controlling them will aid in achieving better seizure control and overall impact the quality of life and wellbeing of epilepsy patients.


Methods: We conducted a retrospective observational study in King Fahad Medical City, Riyadh, Saudi Arabia from April through July 2023 on 259 adult patients with epilepsy.
Collected data included sociodemographic (age, gender, handedness, marital status, level of education & employment) and clinical information (details of epilepsy history, number of antiseizure medications, seizure classification and seizure control, history of seizure related trauma, frequency of seizure, status epilepticus related emergency department (ED) visits and intensive care unit (ICU) admissions & history of previous epilepsy surgery) of each participant.
Arabic translated and validated Fatigue Severity Scale (FSS) questionnaire was used to assess the presence and severity of fatigue. A total score of ≥ 4 was interrupted as presence of fatigue and adversely, score < 4 meant there was no fatigue. The severity of fatigue corresponds to the score, as higher scores reflect more sever fatigue.


Results: The mean FSS was 3.2 ± 1.6. Fatigue was present in 89 (34.4%) patients (scored ≥ 4 in FSS) out of the 259. 170 (65.6%) had no fatigue (scored < 4). Fatigue occurrence in females was slightly higher 58 than in males (65.2%) and 31 (34.8%).
Of the 150 (57.9) patients with uncontrolled epilepsy 66 (44%) had fatigue. Good compliance on ASMs was reported by 232 (89.9), of those 153 (65.9%) had no fatigue and 79 (34.1%) had fatigue. Patients who were not complaint on treatment were 27 (10.4%), of those 10 (37%) had fatigue.Among patients with fatigue (FSS ≥ 4) 41 (32.5%) had recurrent ED visits and 15 (31.9%) had one or more ICU admission due to SE.80 patients (31.1%) reported history of seizure related trauma. 30 (37.5%) patients in this group had fatigue.Epilepsy was classified as focal in 173 (66.8%), generalized in 74 (28.6%) and unclassified in 12 (4.6%). Fatigue (FSS scored ≥ 4) was found in 62 (35.8%) patients who had focal epilepsy, in 25 (33.8%) patients with generalized and in 2 (16.7%) patients with unclassified epilepsy.There was no statistically significant difference in the prevalence of fatigue based on patient’s level of education, current employment or marital status.There were also no major differences in fatigue occurrence based on years of epilepsy, epilepsy classification, compliance to ASMs or the number of ASMs the patient is taking.


Conclusions: Fatigue is commonly found in epilepsy patients. It is prevalent variably and independently among multiple epilepsy patients characteristics. Further studies on possible predictors of fatigue, risk factors and its management in epilepsy patients are needed.