Abstracts

Rationale: 66 % of US population (71 % men,61% women) is overweight, defined as body mass index (BMI) of >25 kg/m2 or obese, defined as BMI of >30 kg/m2 [1]; 32% of all US adults are obese. Patients with epilepsy may have a greater risk for obesity than the general population because they are often sedentary and may be treated with weight gain-causing AEDs. In addition, it is possible that epilepsy could affect the neuroendocrine control of energy metabolism, similar to its effect on reproductive endocrine function. Prevalence of obesity has not been systematically studied in patients with epilepsy [2]. The goal of the present study was to determine the prevalence of obesity in the epilepsy patient population. Methods: This was a cross-sectional study. All epilepsy patients evaluated at a single epilepsy center between 9/2003-5/2009 had weight and height measured and BMI calculated as part of routine initial physical examination. Epilepsy evaluation included EEG and, where normal, sleep deprived EEG or LTEEG, and MRI. Patients with possible non-epileptic seizures were excluded. Data were analyzed using χ2 or Fisher’s exact test, ANOVA and logistic regression analysis Significance was set at p<0.05. Results: 574 patients with epilepsy were evaluated (361, 62.9% women, age range 5-87, 91% adults, 85% aged 16-75). 276 (48.1%) were overweight.124 (21.6%) were obese. 24 (4.2%) were morbidly obese (BMI >40 kg/m2). 56 % men and 43.2 % women were overweight, 19% men and 22.3% women were obese, and 2.3% men and 5% women were morbidly obese. 68 (11.8%) patients had primary generalized epilepsy (PGE), 499 (86.9%) had localization-related epilepsy (LRE), and 7 (1.2%) had multiple or indeterminate epilepsy types. There was no statistically significant difference between overweight and obesity prevalence in PGE and LRE patients: 44.1% of PGE patients were overweight, 14.6% obese and 4.4% morbidly obese compared to 48.3%, 22.6% and 4.2% of LRE patients [NS]. There was no statistically significant difference in rates of overweight and obesity between patients treated with potentially weight-gain causing AEDs and patients treated with other AEDs. Rates for overweight, obesity and morbid obesity for all patients treated with valproate, pregabalin, gabapentin, or carbamazepine were 58.6%, 24.6%, and 0. Seizure severity, age at seizure onset were likewise not related to BMI. Conclusions: Obesity is common in epilepsy patients, but with similar overweight/obesity rates as those seen in general population [1]. There are no clear epilepsy-related predisposing risk factors.