The effect of COVID-19 pandemic on seizure control and self-reported stress on patient with epilepsy

Abstract

The objective of the study was to assess if patients with epilepsy (PWE) experienced an increase in seizure frequency and self-reported stress during the COVID-19 pandemic. Methods: This is a cross-sectional study conducted in Saudi Arabia in April 2020. An electronic self-administered questionnaire was distributed to PWE via their treating neurologist. The variables included were demographic and baseline clinical characteristics (age, gender, living situation, occupational status, type of epilepsy, duration of epilepsy, number of antiepileptic medications (AEDs), presence of known psychiatric illness, and use of psychiatric medications), their seizure control in the month prior to the pandemic, perceived stress during this period of time, sleep changes, compliance changes, and change in seizure control during the pandemic. Results: A total of 156 patients completed the questionnaire, with 29.5% reporting an increase in seizure frequency. Additionally, 59.4% reported an increase in self-reported stress and 71.2% experienced a significant change in their sleep during this period. Higher baseline seizure frequency, more AEDs, noncompliance, increase in self-reported stress, and sleep changes are the significant factors associated with increase in seizure frequency during the pandemic. Conclusion: Identifying high-risk patients for seizure recurrence is important in order to provide them with adequate support to reduce such risk.

Correlates of psychological distress in epileptic patients during the COVID-19 outbreak

“…Our single center study revealed two important findings. First, we confirmed that a stressful event, like the COVID-19 outbreak, has the potential to negatively influence the course of a preexisting epilepsy [7,8,9]; second, the existence, in the context of a traumatic event, of a subgroup of patients (i.e. older female patients with higher intrusivity and avoidance and suffering from more marked anxious symptoms) at higher risk of experiencing psychological distress, and likely at higher risk of clinical worsening.…”

“…Notwithstanding the need of such containment measures for guaranteeing public health and safety, COVID-19 outbreak and social lockdown may be appraised as a psychological distressing event causing negative side effects on general [5] as well as on neurological populations such as epileptic patients [6]. To our knowledge few studies, only in the Asian population, [7,8,9] have recently investigated the association between the development of outbreak-related distress and a seizure exacerbation. However, to date no one has analyzed the role played by the different dimensions of psychological distress and its correlation with demographic and clinical features in patients with epilepsy from Western countries.…”

COVID-19, de novo seizures, and epilepsy: a systematic review

“…This significant concern should be addressed in the future through well-designed prospective cohort studies with all relevant confounders controlled. However, evidence showed that many PWE perceived significant disruption in the quality and availability of care to them, and some people reported increase in their seizure frequency since the onset of the pandemic [11,12,14,16,17]. Previous global experiences confirm this piece of evidence.…”

“…In addition, in another study, among 5700 PWE, who were managed at the studied centers, only 14 people tested positive for SARS-CoV-2, without obvious impacts on their epilepsy [18]. Six surveys of PWE showed that many people perceived significant disruption in the quality and availability of care to them (31 to 95%), as well as increased stress and social isolation, and increase in seizure frequency (6 to 35%) since the onset of the pandemic [11,12,[14][15][16][17]. One observational comparative study confirmed that PWE showed more psychological distress than healthy controls, and they spent significantly more time following the COVID-19 outbreak news [13].…”

Effect of the COVID-19 pandemic on drug compliance and stigmatization in patients with epilepsy

“…This made it difficult to evaluate its worsening in epilepsy patients in our study. Alkhotani et al Reported an increase in seizure frequency in 29.5% of their patients during the COVID-19 period in a Saudi Arabia-based study [26] . They found that higher baseline seizure frequency, more AEDs, non-adherence, increased stress, and self-reported sleep changes were important factors associated with an increase in seizure frequency during the pandemic.…”