Clinical characteristics, etiology, and treatment of young adult‐onset epilepsy: A 24‐year retrospective study
Abstract Objective To analyze the clinical characteristics, etiology, drug treatment, and related factors of patients with young adult‐onset epilepsy. Methods The study included patients with epilepsy aged between 18 and 44 years and aimed to analyze the clinical characteristics of epilepsy in young...
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| Format: | Article |
| Language: | English |
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Wiley
2025-02-01
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| Series: | Epilepsia Open |
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| Online Access: | https://doi.org/10.1002/epi4.13126 |
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| author | Xu Zhang Feng Xiang Ziyu Wang Yang Li Chenjing Shao Xiaoyang Lan Senyang Lang Xiangqing Wang |
| author_facet | Xu Zhang Feng Xiang Ziyu Wang Yang Li Chenjing Shao Xiaoyang Lan Senyang Lang Xiangqing Wang |
| author_sort | Xu Zhang |
| collection | DOAJ |
| description | Abstract Objective To analyze the clinical characteristics, etiology, drug treatment, and related factors of patients with young adult‐onset epilepsy. Methods The study included patients with epilepsy aged between 18 and 44 years and aimed to analyze the clinical characteristics of epilepsy in young people and their response to antiseizure medication (ASM) over a 24‐year period (February 1999 and March 2023). Results A total of 4227 patients experienced epilepsy onset between 18 and 44 years of age. The median age of onset was 26 years (interquartile range [IQR]: 21–33), and the median duration from the first seizure to starting treatment was 3 months (IQR: 1.0–6.0). Structural etiology was the most common cause of epilepsy, accounting for 43.2% (1827/4227) of cases, of which head trauma and a history of craniotomy accounted for 64.9% (1186/1827). However, these two causes did not necessarily result in prompt medication or poor epilepsy control. Co‐morbid cognitive decline was more prevalent than headache and anxiety/depression. Multifactorial regression analysis showed that the factors associated with poor seizure control included longer seizure duration (odds ratio [OR] 1.85; 95% confidence interval [CI] 1.58‐2.16; p < 0.001), electroencephalography (EEG) epileptic discharge (OR 1.37; 95% CI 1.17–1.67; p < 0.001), focal seizure (OR 1.69; 95% CI 1.38–2.07; p < 0.001), and seizure clusters (OR 3.35; 95% CI 2.70–4.15; p < 0.001). Initiating treatment after two seizures (OR, 1.18; 95% CI 0.98–1.15; p = .08) or 6 months after the first seizure (OR 0.84; 95% CI 0.67–1.03; p = .09) did not worsen effectiveness. Significance Young adult‐onset epilepsy was frequently caused by head trauma or craniotomies. Co‐morbid cognitive decline was more prevalent than headache and anxiety/depression. The median time from the first seizure to follow‐up treatment was 3 months (IQR: 1.0–6.0). Initiating treatment after two seizures did not necessarily indicate poor drug effectiveness. Plain Language Summary In this article, we observed that young adult‐onset epilepsy was mainly caused by head trauma and craniotomy; co‐morbid cognitive decline was more common. The median duration from first seizure to initiation of treatment for young‐onset epilepsy was 3 months, and more than one‐third of patients experienced more than two seizures prior to treatment, but this factor had no effect on the drug effectiveness. |
| format | Article |
| id | doaj-art-88bf8011f8dd4adca4c664f763358f87 |
| institution | Kabale University |
| issn | 2470-9239 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Epilepsia Open |
| spelling | doaj-art-88bf8011f8dd4adca4c664f763358f872025-02-07T09:12:45ZengWileyEpilepsia Open2470-92392025-02-0110129830610.1002/epi4.13126Clinical characteristics, etiology, and treatment of young adult‐onset epilepsy: A 24‐year retrospective studyXu Zhang0Feng Xiang1Ziyu Wang2Yang Li3Chenjing Shao4Xiaoyang Lan5Senyang Lang6Xiangqing Wang7Department of Neurology The First Medical Center of Chinese PLA General Hospital Beijing ChinaDepartment of Neurology The First Medical Center of Chinese PLA General Hospital Beijing ChinaDepartment of Electrophysiology, Beijing Jishuitan Hospital Capital Medical University Beijing ChinaDepartment of Neurology The First Medical Center of Chinese PLA General Hospital Beijing ChinaMedical School of Chinese PLA Beijing ChinaDepartment of Neurology The First Medical Center of Chinese PLA General Hospital Beijing ChinaDepartment of Neurology Hainan Hospital of Chinese PLA General Hospital Sanya ChinaDepartment of Neurology The First Medical Center of Chinese PLA General Hospital Beijing ChinaAbstract Objective To analyze the clinical characteristics, etiology, drug treatment, and related factors of patients with young adult‐onset epilepsy. Methods The study included patients with epilepsy aged between 18 and 44 years and aimed to analyze the clinical characteristics of epilepsy in young people and their response to antiseizure medication (ASM) over a 24‐year period (February 1999 and March 2023). Results A total of 4227 patients experienced epilepsy onset between 18 and 44 years of age. The median age of onset was 26 years (interquartile range [IQR]: 21–33), and the median duration from the first seizure to starting treatment was 3 months (IQR: 1.0–6.0). Structural etiology was the most common cause of epilepsy, accounting for 43.2% (1827/4227) of cases, of which head trauma and a history of craniotomy accounted for 64.9% (1186/1827). However, these two causes did not necessarily result in prompt medication or poor epilepsy control. Co‐morbid cognitive decline was more prevalent than headache and anxiety/depression. Multifactorial regression analysis showed that the factors associated with poor seizure control included longer seizure duration (odds ratio [OR] 1.85; 95% confidence interval [CI] 1.58‐2.16; p < 0.001), electroencephalography (EEG) epileptic discharge (OR 1.37; 95% CI 1.17–1.67; p < 0.001), focal seizure (OR 1.69; 95% CI 1.38–2.07; p < 0.001), and seizure clusters (OR 3.35; 95% CI 2.70–4.15; p < 0.001). Initiating treatment after two seizures (OR, 1.18; 95% CI 0.98–1.15; p = .08) or 6 months after the first seizure (OR 0.84; 95% CI 0.67–1.03; p = .09) did not worsen effectiveness. Significance Young adult‐onset epilepsy was frequently caused by head trauma or craniotomies. Co‐morbid cognitive decline was more prevalent than headache and anxiety/depression. The median time from the first seizure to follow‐up treatment was 3 months (IQR: 1.0–6.0). Initiating treatment after two seizures did not necessarily indicate poor drug effectiveness. Plain Language Summary In this article, we observed that young adult‐onset epilepsy was mainly caused by head trauma and craniotomy; co‐morbid cognitive decline was more common. The median duration from first seizure to initiation of treatment for young‐onset epilepsy was 3 months, and more than one‐third of patients experienced more than two seizures prior to treatment, but this factor had no effect on the drug effectiveness.https://doi.org/10.1002/epi4.13126antiseizure medicationepilepsyetiologyyoung adult‐onset |
| spellingShingle | Xu Zhang Feng Xiang Ziyu Wang Yang Li Chenjing Shao Xiaoyang Lan Senyang Lang Xiangqing Wang Clinical characteristics, etiology, and treatment of young adult‐onset epilepsy: A 24‐year retrospective study Epilepsia Open antiseizure medication epilepsy etiology young adult‐onset |
| title | Clinical characteristics, etiology, and treatment of young adult‐onset epilepsy: A 24‐year retrospective study |
| title_full | Clinical characteristics, etiology, and treatment of young adult‐onset epilepsy: A 24‐year retrospective study |
| title_fullStr | Clinical characteristics, etiology, and treatment of young adult‐onset epilepsy: A 24‐year retrospective study |
| title_full_unstemmed | Clinical characteristics, etiology, and treatment of young adult‐onset epilepsy: A 24‐year retrospective study |
| title_short | Clinical characteristics, etiology, and treatment of young adult‐onset epilepsy: A 24‐year retrospective study |
| title_sort | clinical characteristics etiology and treatment of young adult onset epilepsy a 24 year retrospective study |
| topic | antiseizure medication epilepsy etiology young adult‐onset |
| url | https://doi.org/10.1002/epi4.13126 |
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