Etiological Profile of Epilepsy in Patients at a Tertiary Care Hospital: An Observational Study: Etiological Profile of Epilepsy in Patients at a Tertiary Care Hospital

Waleed Arshad; Shahbaz Khan; Samahir Akram Nizamani; Abdul Hafeez Bughio; Manzoor Ali Lakhair

doi:10.54393/pjhs.v7i2.3283

Authors

Waleed Arshad Department of Neurology, Liaquat University of Medical and Health Sciences, Hospital, Jamshoro, Pakistan
Shahbaz Khan Department of Neurology, Liaquat University of Medical and Health Sciences, Hospital, Jamshoro, Pakistan
Samahir Akram Nizamani Department of Neurology, Liaquat University of Medical and Health Sciences, Hospital, Jamshoro, Pakistan
Abdul Hafeez Bughio Department of Neurology, Liaquat University of Medical and Health Sciences, Hospital, Jamshoro, Pakistan
Manzoor Ali Lakhair Department of Neurology, Liaquat University of Medical and Health Sciences, Hospital, Jamshoro, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v7i2.3283

Keywords:

Epilepsy, International League Against Epilepsy Classification, Electroencephalography, Magnetic Resonance Imaging

Abstract

Epilepsy has diverse etiologies that vary by age, gender, and region. Identifying the cause is essential for management and prognosis. Objectives: To determine the etiological profile of epilepsy in patients at a tertiary care hospital and assess associations with age and gender. Methods: This observational study was conducted in the Department of Neuro-medicine, Liaquat University of Medical and Health Sciences, Jamshoro, from March 15 to September 14, 2022. A total of 156 patients aged ≥18 years with epilepsy for over five years were enrolled by consecutive sampling. Those with acute symptomatic seizures or incomplete records were excluded. Etiologies were classified using International League Against Epilepsy 2017 criteria based on electroencephalography and magnetic resonance imaging. Results: A total of 156 adult epilepsy patients were included (mean age 54.7 ± 15.6 years; 101 male, 55 female). Acute ischemic stroke was the most common etiology, 74 (47.4%), followed by idiopathic epilepsy, 29 (18.6%), brain tumors, 15 (9.6%), traumatic brain injury, 13 (8.3%), intracerebral hemorrhage, 10 (6.4%), CNS infections, 8 (5.1%), and encephalitis, 11 (7.1%). A higher proportion of female was observed within the brain tumor and idiopathic epilepsy subgroups, 10 (66.7%) and 19 (65.5%), respectively (p < 0.05); however, these findings reflect distribution within the tertiary cohort and should not be interpreted as population-level risk. Insignificant associations were found between etiology and age group or epilepsy duration. Conclusions: Acute ischemic stroke was the leading cause of epilepsy, with significant gender differences for brain tumors and idiopathic epilepsy.

References

Ullah S, Ali N, Khan A, Ali S, Nazish HR. The Epidemiological Characteristics of Epilepsy in the Province of Khyber Pakhtunkhwa, Pakistan. Frontiers in Neurology. 2018 Nov; 9: 845. doi: 10.3389/fneur.2018.00845. DOI: https://doi.org/10.3389/fneur.2018.00845

Jawaid W, Nisa Q, Umer SR, Barry SJ, Qureshi A, Shahbaz NN. Etiology and Types of Seizures in Patients Presenting to a Tertiary Care Hospital in Karachi: A Cross-Sectional Study. Cureus. 2020 Jul; 12(7). 1-10. doi: 10.7759/cureus.9194. DOI: https://doi.org/10.7759/cureus.9194

Ali N, Dharamshi HA, Mustahsan S, Noorani S. Etiology and Outcomes of New Onset Seizure in Adult Patients: A Clinical Experience from the Emergency Department of a Tertiary Care Center. Pakistan Journal of Medical Sciences. 2022 May; 38(5): 1382. doi: 10.12669/pjms.38.5.4411. DOI: https://doi.org/10.12669/pjms.38.5.4411

Badshah N, Ahmad S, Khan SH, Qureshi SA, Sarwar MT. Epilepsy in the Consanguineous Families at Tribal Society of Khyber Pakhtunkhwa, Pakistan. Journal of Medical Sciences. 2022 Apr; 30(1): 32-36. doi: 10.52764/jms.22.30.1.7. DOI: https://doi.org/10.52764/jms.22.30.1.7

Anjum N, Zafar F, Yousuf M, Khattak ZU. Efficacy and Safety of the Ketogenic Diet Therapy in Pakistani Children with Refractory Epilepsy. Khyber Medical University Journal. 2023 Jun; 15(2): 111-115.

Bhatia MS, Sharda SC, Yadav G, Mehta S, Attri R, Singla N. Etiology of New-Onset Seizures in Adult Patients of Different Age Groups Presenting to The Emergency Department in North India and Their Outcomes. Journal of Family Medicine and Primary Care. 2022 Nov; 11(11): 7129-7135. doi: 10.4103/jfmpc.jfmpc_730_22. DOI: https://doi.org/10.4103/jfmpc.jfmpc_730_22

Tabassum S, Soomro MH, Ali A, Ahmed I, Shafique S, Rahman M et al. The Status Epilepticus in Adults: Results from a Tertiary Care Teaching Hospital in Karachi, Pakistan. Bangladesh Journal of Medical Science. 2023 Jan; 22(1): 128-134. doi: 10.3329/bjms.v22i1.61861 DOI: https://doi.org/10.3329/bjms.v22i1.61861

Hassan F, Ali S, Munir M, Masood A, Obaid MS, Baig RU et al. Assessment of Frequency of Electroencephalogram Findings in Children with Epilepsy in A Tertiary Care Hospital in Karachi, Pakistan: Frequency of Electroencephalogram Findings in Children with Epilepsy. Pakistan BioMedical Journal. 2022 Jun: 258-261. doi: 10.54393/pbmj.v5i6.565. DOI: https://doi.org/10.54393/pbmj.v5i6.565

Jourahmad Z, Habibabadi JM, Moein H, Basiratnia R, Geranqayeh AR, Ghidary SS et al. Machine Learning Techniques for Predicting the Short-Term Outcome of Resective Surgery in Lesional Drug-Resistant Epilepsy. arXiv preprint arXiv. 2023 Feb: 1-10.

Asadi-Pooya AA, Damabi NM, Fazelian K, Moshfeghinia R, Niknam N. How to Successfully Establish an Epilepsy Care Center in Resource-Limited Countries: A Scoping Systematic Review. Seizure: European Journal of Epilepsy. 2023 Jul; 109: 92-96. doi: 10.1016/j.seizure.2023.06.001. DOI: https://doi.org/10.1016/j.seizure.2023.06.001

Mahmoud MH, Awad EM, Mohamed AK, Shafik MA. Etiological Profile of New-Onset Seizures Among Adult Egyptians. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 2021 Jul; 57(1): 95. doi: 10.1186/s41983-021-00349-6. DOI: https://doi.org/10.1186/s41983-021-00349-6

Mafla-Mendoza AP, Paredes-Urbano ED, Gea-Izquierdo E. Risk Factors Associated with Epilepsy Related to Cerebrovascular Disease: A Systematic Review and Meta-Analysis. Neuropsychiatric Disease and Treatment. 2023 Dec: 2841-2856. doi: 10.2147/NDT.S439995. DOI: https://doi.org/10.2147/NDT.S439995

Masroor M, Bakhshi SK, Shamim MS. Seizure Outcomes After Meningioma Resection. The Journal of the Pakistan Medical Association. 2022 Apr; 72(4): 776-778. doi: 10.47391/JPMA.22-31. DOI: https://doi.org/10.47391/JPMA.22-31

Huang X, Mao L, Lin Q, Huang K, Li Y, Liu P et al. Voxel-Based Meta-Analysis of Gray Matter Abnormalities in Idiopathic Generalized Epilepsy. Cerebral Cortex. 2025 Aug; 35(8): 201. doi: 10.1093/cercor/bhaf201. DOI: https://doi.org/10.1093/cercor/bhaf201

Habib R, Haque MR, Khan MS, Alam D, Islam MR. Acute Symptomatic Seizures in Adults: A Study on Etiological Profile. Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders Medical Journal. 2022 May; 12(2): 99-105. doi: 10.3329/birdem.v12i2.59609. DOI: https://doi.org/10.3329/birdem.v12i2.59609

Masood R, Malik M, Rana MT, Habib S, Nawaz A, Habib T. Clinical Outcomes and Frequency of Electroencephalographic Abnormalities in Patients with First Unprovoked Seizure in a Tertiary Care Hospital. Pakistan Journal of Health Sciences. 2025 Jun; 6(6): 144 148. DOI: https://doi.org/10.54393/pjhs.v6i6.2363

Makkawi S, Alshehri FS, Malaikah AA, Alghamdi AM, Al-Zahrani RM, Nahas RJ et al. Prevalence of Etiological Factors in Adult Patients with Epilepsy in a Tertiary Care Hospital in the Western Region of Saudi Arabia: A Cross-Sectional Study. Cureus. 2023 Jan; 15(1). doi: 10.7759/cureus.33301. DOI: https://doi.org/10.7759/cureus.33301

Hameed AN, Nawaz MT, Hamza Khan MM, Tauqeer H, Angez M, Nazir Khan MM. Surveillance of Aetiologies, Clinical Presentation, and Most Common Types of Epilepsy Among Paediatric Patients at a Tertiary Care Hospital in Pakistan. The Journal of the Pakistan Medical Association. 2023 Mar; 73(3): 723-727. doi: 10.47391/JPMA.6200. DOI: https://doi.org/10.47391/JPMA.6200

Zhang X, Wang Z, Xiang F, Li Y, Shi X, Shao C et al. Etiologies of Patients with Adult-Onset Epilepsy Over the Past 25 Years: A Retrospective Study in China. BioMed Center Neurology. 2025 Dec; 25(1): 512. doi: 10.1186/s12883-025-04511-y. DOI: https://doi.org/10.1186/s12883-025-04511-y

Beghi E, Giussani G, Sander JW, Perucca E, Hauser WA, Hesdorffer DC et al. The Epidemiology of Epilepsy: A Systematic Review of Population-Based Studies. Epilepsia. 2023; 64(2): 321-341.