The Effect of Virtual Learning on Seizure Control Among Epilepsy Patients in Saudi Arabia

Abstract

Background: The pandemic of COVID-19 has resulted in multiple precautions to control the infection, one of which is transforming students’ schools into virtual classrooms. These new situations may pose additional challenges for some individuals such as epilepsy patients who account for 5.5% of school children (6–18 years). This study aimed to determine the effect of virtual learning on seizure control among epilepsy patients. Methods: This is an online-based cross-sectional study that was performed between 17 February to 27 June 2021 among patients with epilepsy who attend virtual learning classes. The questionnaire was distributed to the patients at a single-center neurology clinic in Mecca, Saudi Arabia. We included all patients who were diagnosed with epilepsy at any hospital, aged between 10 to 30 years, and living in Saudi Arabia. Results: A total number of 70 patients were included in the study. Patients’ gender was nearly equally distributed between the two groups with females predominant (51%). The average time of more than 10 hours spent on screens and electronic devices was remarkably increased during COVID-19 (20.0% to 45.7%). The average number of seizures per year has a double-fold increase during the pandemic for ≥7 attacks (increased from 10% to 20%). More than half of the patients had a significant increase in their seizure frequencies during virtual learning (60%). Patients with focal epilepsy, a history of photosensitivity, and patients with disturbed sleep patterns are significant risk factors associated with increased seizure frequencies during virtual learning. Conclusions: Focal epilepsy, history of photosensitivity, and disturbed sleep pattern associated with increased seizure frequencies during virtual learning. Time spent on screen has no significant relation to increasing seizure frequencies. Identifying the patients’ risk and taking a serious step in reducing its sources is important in order to provide a better quality of life.

Demographics, Clinical Characteristics, and Management Strategies of Epilepsy in Saudi Arabia: A Systematic Review

“…Only six studies assessed the educational level of the participants; of these, four showed a predominance of high-school educational level [ 24 , 26 , 29 , 31 ]. While the predominance was for bachelor’s degrees of education in two studies [ 27 , 30 ].…”

“…As for the clinical characteristics of patients with epilepsy included in this systemic review, five studies showed a higher prevalence of generalized tonic-clonic epilepsy type [ 11 , 17 , 23 , 26 , 31 ], five studies showed a predominance of focal epilepsy type [ 21 , 22 , 25 , 27 , 28 ], and three studies did not assess the epilepsy type [ 24 , 29 , 30 ].…”

“…Only five studies assessed the frequency of the seizures, where 68.7% of patients in the Alkoblan et al 2023 study had seizures on a yearly basis [ 24 ], 33% had monthly seizures in the Asiri et al 2022 study [ 26 ], and 61.4% had up to three seizures per year in the A. Alharbi et al 2022 study [ 27 ]. At the same time, 48.1% were seizure-free over the previous 3 months in the Alshamrani et al 2020 study [ 30 ] and 57.7% had ≤5 seizures before treatment [ 22 ].…”

“…Nine studies assessed the management strategy of the studied patients. Of these studies, five studies showed a higher prevalence of monotherapy regimens [ 17 , 21 , 22 , 25 , 26 ], three studies showed a higher prevalence of polytherapy anti-epileptic medicine (AEM) regimens, while three studies did not assess the management strategy [ 27 , 28 , 31 ].…”

“…Based on the AEM utilized in this research, three studies demonstrated a greater incidence of polytherapy AEM regimen and five studies demonstrated a higher prevalence of monotherapy AEM regimen [ 17 , 21 , 22 , 25 , 26 ]. Three studies did not evaluate the management strategy that was employed [ 27 , 28 , 31 ]. A prior study found that monotherapy AEM regimens were more common and that the most often prescribed medications were carbamazepine, valproic acid, phenobarbital, and lamotrigine [ 32 ].…”