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Profile and associated factors for re-admitted epileptic patients with complications in a South African hospital.

OBJECTIVE
The profile and associated factors for re-admitted epileptic patients with complications was determined. Repeated re-admission to Komani Hospital initiated the study to identify preventable factors aimed at reducing readmission of these patients.


DESIGN
Descriptive study.


SETTING
Komani Hospital, Queenstown, South Africa.


SUBJECTS
101 patients previously diagnosed with epilepsy and who were re-admitted to Komani Hospital with post-ictal complications, were included.


MAIN OUTCOME MEASURES
Epileptic patients were identified on admission and were interviewed. Information of the post-ictal events was gathered from people accompanying the patient and who had witnessed the seizure. Patient information about associated factors like substance abuse, level of education, employment status, compliance, drug regimes and other issues were explored.


RESULTS
Many (63%) patients were unemployed, 54% of the patients used alcohol and 24% had a history of substance abuse (cannabis). Most patients (71%) gave no family history of epilepsy. 10% of the patients had frequent seizures (once a week or once every two weeks) and 55% of the patients had infrequent seizures (once a month). More than a third (35%) of the patients had good control of seizures (once a year up to a maximum of three attacks per year). Most patients (97%) were on monotherapy. For (35%) of patients this was a second admission, with second and third admission representing more than 60% of patients. Most patients (56.4%) experienced myoclonic seizures (data gathered from patient notes, referral letters and collateral information) with a seizure frequency of at least once a month. Post-ictal psychosis was the most common cause of admission (68%).


CONCLUSION
The onset of epilepsy in most patients was on or after 20 years of age. According to patient notes, referral letters and-collateral information, the majority of patients experienced myoclonic type seizures with a frequency of at least once a month or more. Most patients were stabilized on monotherapy and post-ictal psychosis was the most common cause of re-admission. Cannabis and alcohol use in the study group is of note.