Driving Habits Among Patients With Epilepsy in a Tertiary Care Hospital in Saudi Arabia.

Objective: Patients with epilepsy are instructed to avoid high-risk situations such as certain occupations and driving to prevent harm to themselves and others. There is considerable variation in standards to decide if a patient with epilepsy is fit to drive among various countries worldwide, and these patients often continue to drive despite being advised not to. The objective of this study was to determine if patients with epilepsy and uncontrolled epilepsy are driving, the awareness of epilepsy patients regarding driving, and whether physicians are advising the patients to stop driving.Methods: A clinic-based study was conducted in Saudi Arabia from June 2018 through January 2019 with structured interviews of consecutively recruited male patients with established epilepsy diagnosis. Demographic factors, employment status, control of seizures, and awareness of driving restrictions were documented.Results: The response rate was 80.6%. Of the 121 participants (mean age of 35.97 years), 110 (90.9%) were driving, and 39% of those patients were married. Also, 76.9% of participants were employed. Of the participants, 48.8% had 1 seizure in the last 6 months, and 88% of those patients were driving; 51.2% had not had a seizure in the last 6 months, and 93% of those patients were driving. Additionally, 17.4% reported a seizure attack while driving. Only 38% of respondents were aware they should stop driving, whereas 62% were unaware of driving restrictions.Conclusions: There is a definite need to establish a driving policy for patients with epilepsy and to optimize the standards of care of epilepsy patients in Saudi Arabia to ensure minimization of harm to both patients and the public.

Preventable Etiologies of Epilepsies in Saudi Arabia: A Tertiary Care Experience.

Objective: To determine the etiologies of epilepsy in a cohort of patients using the International League Against Epilepsy 2017 classification system and to determine frequencies of preventable causes and their clinical characteristics.Methods: Epileptic patients in neurology clinics at a tertiary care hospital were prospectively recruited from June 1, 2018, to November 30, 2018. Patients were divided according to their respective etiologic categories. Traumatic brain injury, stroke, hypoxic-ischemic encephalopathy, and central nervous system infections were considered preventable etiologies.Results: A total of 160 patients were included in the study. Of these patients, 61 had epilepsy of unknown etiology, while among the remaining 99 patients in whom etiology could be identified, traumatic brain injury was the most frequent overall cause with 17 (17.2%) cases. Frequencies in other etiologies were genetic (idiopathic generalized epilepsy): n = 14, stroke: n = 13, hypoxic-ischemic encephalopathy: n = 13, cerebral tumors: n = 10, mesial temporal sclerosis: n = 9, cortical malformation: n = 7, and other structural pathologies: n = 5. Other rarer causes (including central nervous system infections) had less than 5 patients each. When the preventable etiologies were grouped, they formed 46 of 99 patients (46.5%) with identifiable etiology. Seizure control was mostly satisfactory in the total sample (126/160 [78.8%]), including patients with preventable etiologies, of whom 50% were on polytherapy.Conclusions: Epilepsies with preventable etiologies are common in our clinics. Studies are needed in other centers to identify epilepsy etiologies and confirm our findings, which may help determine better strategies for primary prevention of epilepsy.

Migraine Prevalence, Characteristics, Triggers, and Coping Strategies Among Medical Students in Saudi Arabia.

Objective: To determine the prevalence, characteristics, and triggers of migraine and coping strategies used among medical students in Saudi Arabia.Methods: This cross-sectional descriptive study was conducted among undergraduate students in the College of Medicine of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Included students were in their second to sixth academic year of the Bachelor of Medicine or Bachelor of Surgery programs during the 2019-2020 academic year. The diagnosis of migraine was made according to the International Classification of Headache Disorders, Third Edition criteria.Results: A total of 396 students participated in the study; 238 (60.1%) were female and 158 (39.9%) were male. Their age ranged between 18 and 26 years old, with a mean age of 21.32 ± 1.659 years. Only 16 of 396 students fulfilled the criteria for migraine, with a prevalence of 4.04%. Migraine prevalence was higher in females (n = 11, 4.6%) compared to males (n = 5, 3.1%), with a female:male ratio of 1.5:1. The most common triggers associated with migraine were study-related stress (88%) and emotional-related stress (81%).Conclusions: This project was undertaken to evaluate prevalence, triggers, and coping strategies of migraine among medical students. The prevalence of migraine headache in this study was lower compared to other national and international universities, with a higher female to male ratio. Stress was a major trigger among our study population. The findings of this study will add to the growing body of literature on migraine.