Abstract:
Epilepsy is a chronic neurological disease with variable therapeutic responses. To
design effective treatment strategies for epilepsy, it is important to understand treatment
responses and predictive factors. However, there are many controversies and inconclusive pieces
of evidence about the remission pattern of epilepsy patients in developing countries. Besides, the
studies available in the Ethiopia setting are negligible, particularly that addressed children.
Objective: This study aimed to determine the pattern of seizure remission and associated factors
among epileptic patients on follow-up in Hiwot Fana Specialized University Hospital and
Dilchora Referal Hospital, from July 2 to 31, 2021.
Methods: A retrospective cohort study was conducted at Hiwot Fana Specialized University
Hospital and Dilchora Referal Hospital, Eastern Ethiopia. A data collection tool was developed
to record relevant information from existing medical records. Data were analyzed by using SPSS
Version 21.0. The data was presented using the mean and median for continuous variables or
frequency for categorical variables. A univariable and multivariable Cox proportional hazards
model was performed to determine the association of each independent variable with seizure
remission. A p-value of < 0.05 at a 95% Confidence interval was used to establish a statistically
significant association.
Result: A total of 418 patients were included in the study from two hospitals. Among them, 276
(66%) were adults and 178(42.6%) have encountered the hospitals a year after the disease onset.
Among included study participants, 252 (60.3%) of them revealed to achieve seizure remission.
In multivariable Cox proportional analysis, epileptic patients who were taking dual therapy were
44% less likely to achieve remission (AHR=0.56, 95% CI: 0.32-0.98), patients who had < 12
months pretreatment duration were 2.361 times more likely to achieve remission (AHR=2.36,
95% CI: 1.28-4.37) and participants who had good adherence to anti-epileptics were 2.4 times
more likely to achieve remission (AHR= 2.4, 95% CI: 1.33-4.34).
Conclussion: In this study, more than a third of patients have never achieved remission during
the follow-up and the remitting relapsing course was the most common remission pattern. Taking
more than one antiseizure medication, longer pretreatment duration and non-adherence to
medication were the contributors to poor remission. Patients with those characteristics should be
addressed with due attention
