Epilepsy in Eastern Algeria: Epidemiological Characteristics, Comorbidities, Risk Factors, and Antiseizure Medication Patterns in Clinical Practice

Abstract

Background: Epilepsy is a chronic neurological disorder with substantial clinical, social, and functional consequences. Its multifactorial etiology involves genetic and environmental factors, while comorbidities, inadequate seizure control, and long-term treatment requirements may further increase its impact on patients’ quality of life. This study aimed to characterize the clinical, socio-demographic, familial, comorbidity, and antiseizure treatment profiles of people with epilepsy in an Algerian population.

Methods: A cross-sectional descriptive study was conducted from February to April 2023 among 78 patients with epilepsy, with or without a family history of epilepsy. Data were collected using a standardized questionnaire covering socio-demographic characteristics, age at seizure onset, seizure type and frequency, family history, consanguinity, educational and occupational status, associated comorbidities, antiseizure medications, treatment regimen, and treatment adherence. The association between seizure type and antiseizure treatment was assessed using the chi-square test of independence.

Results: The study population was predominantly young, with a mean age of 21 years. Childhood-onset epilepsy was prominent, with 43.6% of patients experiencing their first seizure between 1 and 10 years of age. Generalized tonic-clonic seizures were the most frequently reported seizure type (50.4%), and 53.1% of patients experienced more than six seizures during the preceding 12 months. Monotherapy was the most commonly used treatment regimen, with sodium valproate (33%) and levetiracetam (31%) being the most frequently prescribed antiseizure medications. Sodium valproate was frequently used among patients with generalized tonic-clonic seizures (35.9%) and absence seizures (46.2%), whereas levetiracetam was frequently prescribed among patients with complex partial seizures (45.5%) and generalized tonic-clonic seizures (30.8%). However, no statistically significant association was observed between seizure type and antiseizure treatment (χ²(25) = 33.93, p ≈ 0.11). Self-reported adherence to antiseizure medication was high (98.7%). A family history of epilepsy was reported in 29.5% of patients, while consanguinity was particularly frequent (69.6%). The socio-educational burden was substantial: 37.2% of patients had never attended school, 34.6% had not completed primary education, approximately three-quarters were unemployed, and 53% were single. Intellectual disability was the most common comorbidity (33%), followed by hypertension (23%); diabetes, stroke, and heart disease were each reported in 10% of patients, and autism spectrum disorder in 5%.

Conclusion: Epilepsy in this Eastern Algerian population was characterized by early onset, frequent seizures, high consanguinity, substantial socio-educational impairment, and a considerable burden of cognitive and cardiometabolic comorbidities. Monotherapy predominated, with sodium valproate and levetiracetam being the most frequently prescribed antiseizure medications, while treatment adherence was highly reported. Although treatment patterns varied descriptively according to seizure type, no statistically significant overall association was observed, and prescription frequency should not be interpreted as evidence of comparative treatment efficacy. These findings support the need for early diagnosis and individualized, multidisciplinary management integrating seizure control and appropriate antiseizure treatment with cognitive, developmental, genetic, and socio-professional care, particularly in populations with high rates of consanguinity.