Prevalence of Comorbidity of Migraine and Atopic Diseases among Patients with Idiopathic Epilepsy in Zagazig University Hospitals

摘要

Comorbid conditions are common in people with epilepsy, and their presence has important implications for diagnosis, treatment, medical costs and quality of life. Migraines are most common in patients with epilepsy, with a reported prevalence of 20-40%, while epidemiologic studies on the association between allergic disease and epilepsy in adults and children have found conflicting results. Objectives: The study was designed to assess the prevalence of migraine and atopic diseases: bronchial asthma(BA) and atopic eczema in patients with idiopathic epilepsy. Methods: This study included 118 patients with idiopathic generalized epilepsy(IGE), 68 male and 50 female with ages ranged from 2-20 years (mean age 9.8±5.4 years). The patient will be considered :to have migraine according to criteria of ICHD 3 (2013), to have BA according to diagnostic criteria of National Asthma Education and Prevention Program (2007) and to have atopic eczema according to Williams criteria (1994). The patients were classified into two groups, group Ι epileptic patients without comorbidity and groupΙΙ epileptic patients with comorbidity which was further classified into 2 subgroups, groupΙΙ-A epileptic patients with one comorbidity, group ΙΙ-B epileptic patients with multiple comorbidity. All patients were subjected to: clinical assessment via thorough history taking, complete general and neurological examination, EEG, MRI brain and routine laboratary investigations. The data were compared in both groups. Results: IGE was more common in male than female (55.9 % vs 44.1 %). Atopic eczema was the most frequent comorbid illness (32.2%) followed by migraine (24.6%) and BA (24.6%) while The prevalence of atopic eczema, migraine and BA and in the general population was 20%, 15% and 4%-20%, respectively. Epileptic patients with multiple comorbidities had a statistically significant older age of onset than epileptic patients one comorbidity and without comorbidities (P= 0.001). Also female sex was statistically significant higher in epileptics with comorbidities. Epileptics with migraine had female preponderence (69%). MA was more common (79.3%). Migraine onset followed epilepsy onset in 48.2%.Migraine attacks occurred mostly interictally. The bronchial asthma comorbidity in our patients was with a more prominent onset before epilepsy (76%). Mild asthma was more common in epileptics in our study and it was common postictally. Atopic eczema comorbidity in our patients was with an onset more commonly prior to that of epilepsy & it occurred in a mild form and usually interictally. Conclusion: Patients with IGE had comorbidity with atopic eczema (32.2%) migraine (24.6%) and BA (24.6%).Family history for epilepsy was more in patients with comorbidity and they need polytherapy of AEDs more than those without comorbidity.