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Risk estimation of SUDEP during COVID-19 pandemic era in a tertiary referral center.
Magdy, Rehab; Kishk, Nirmeen A; Fouad, Amr M; Alsayyad, Enas.
  • Magdy R; Department of Neurology, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: rehab.m.hassan@kasralainy.edu.eg.
  • Kishk NA; Department of Neurology, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
  • Fouad AM; Department of Neurology, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
  • Alsayyad E; Department of Neurology, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
Epilepsy Res ; 173: 106625, 2021 07.
Article in English | MEDLINE | ID: covidwho-1157287
ABSTRACT

OBJECTIVE:

No data exist regarding the impact of the lockdown due to the COVID-19 pandemic on the risk factors of sudden unexpected death in epilepsy (SUDEP). This study aimed to stratify risk factors of SUDEP in relation to COVID-19 lockdown, among patients with epilepsy (PWE) in Cairo University epilepsy unit (CUEU). Therefore, we can detect risk factors and mitigate such factors in the second wave of the virus.

METHODS:

an observational, cross-sectional study carried on 340 Egyptian patients with active epilepsy. Individual risk identification and stratification was done by using The SUDEP and seizure Safety Checklist, after which sharing risk knowledge to PWE and their caregivers was undertaken.

RESULTS:

The mean age of patients was 29.72 ± 12.12. The median of the static factors was 4 (IQR 3-5) whereas, the median of the modifiable factors was 2 (IQR 1-3). Epilepsy emergencies (serial seizures or status epilepticus) were reported in 24.1 % of patients, for which non-compliance was the commonest cause, followed by deferral of epilepsy surgery for patients with drug resistant epilepsy (DRE). Stepwise logistic regression analysis showed that use of anxiolytic medications, non-compliance, keeping patients with DRE on dual anti-seizure medications (ASMs), or adding third medication increased the odds of increased seizure frequency by 2.7, 3.5, 16.6 and 6.1 times, respectively.

CONCLUSION:

Some COVID-19 related issues had influenced the risk of seizure worsening including postponing epilepsy surgery for patients with DRE, non-compliance, and psychiatric comorbidities. Special attention should be paid to these issues to mitigate the risk of SUDEP.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / Sudden Unexpected Death in Epilepsy / COVID-19 Type of study: Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Adolescent / Adult / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Africa Language: English Journal: Epilepsy Res Journal subject: Brain / Neurology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / Sudden Unexpected Death in Epilepsy / COVID-19 Type of study: Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Adolescent / Adult / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Africa Language: English Journal: Epilepsy Res Journal subject: Brain / Neurology Year: 2021 Document Type: Article