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Research ArticleOriginal Articles
Open Access

Beyond Seizures: The hidden burden of fatigue in epilepsy

Alia MR. Fallatah, Malak R. Albadrani, Sarah A. Alsalman, Weam K. Almasuad, Abdulrahim M. Hamhom, Sumayah M. Almarshedy, Faisal A. Alsallom, Fawzya A. Bamogaddam, Majed H. Alhameed and Mubarak M. Aldosari
Neurosciences Journal October 2025, 30 (4) 278-285; DOI: https://doi.org/10.17712/nsj.2025.4.20250011
Alia MR. Fallatah
From the National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
MD
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  • ORCID record for Alia MR. Fallatah
  • For correspondence: aliaf{at}moh.gov.sa
Malak R. Albadrani
From the National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
MD
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Sarah A. Alsalman
From the National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
MD
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Weam K. Almasuad
From the National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
MD
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Abdulrahim M. Hamhom
From the National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
MD
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Sumayah M. Almarshedy
From the National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
MD
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Faisal A. Alsallom
From the National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
MD
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Fawzya A. Bamogaddam
From the National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
MD
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Majed H. Alhameed
From the National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
MD
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Mubarak M. Aldosari
From the National Neuroscience Institute, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
MD
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  • Article
  • Figures & Data
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Article Figures & Data

Figures

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  • Figure 1
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    Figure 1

    - Prevalence of fatigue in PWE. *PWE = Patients with epilepsy

  • Figure 2
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    Figure 2

    - Correlation between FSS and PHQ-9 scores.

Tables

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    Table 1

    - Sociodemographic characteristics of participants.

    Characteristicsn%
    Sex
    Female13150.6
    Male12849.4
    Age (year)
    ≤20259.7
    21–3011042.5
    31–409637.0
    41–502610.0
    >5020.7
    Mean ± SD30.2±8.6
    Handedness
    Left2710.4
    Right23289.6
    Education level
    Below high school249.3
    High school9335.9
    Graduate13652.5
    Postgraduate62.3
    Marital status
    Single12447.9
    Married12648.6
    Divorced72.7
    Widowed20.8
    Employed
    No10440.2
    Yes15559.8
    Work timing
    Day time13083.8
    Shifts (morning, evening, or night)2516.1
    • View popup
    Table 2

    - Clinical characteristics of participants.

    CharacteristicN (%)
    Years of epilepsy
    1–555 (21.2)
    5–1062 (23.9)
    10–2086 (33.2)
    >2056 (21.6)
    Epilepsy classification
    Focal173 (66.8)
    Generalized74 (28.6)
    Unclassified12 (4.6)
    Focal epilepsy localization173 (66.8)
    Temporal81 (46.8)
    Frontal46 (26.5)
    Partial18 (10.4)
    Occipital11 (6.3)
    Insular4 (2.3)
    Others (e.g. multi-lobar, or pineal)13 (7.5)
    MRI
    Non-lesional136 (52.5)
    Lesional123 (47.5)
    Seizure Control
    Uncontrolled (last seizure ≤ 1 year)156 (60.2)
    Controlled (last seizure >1 year)103 (39.7)
    Seizure frequency over last 6 months for patients with uncontrolled seizures (n = 156)
    Daily15 (9.6)
    Weekly22 (14.1)
    Monthly42 (26.9)
    Once in 3–6 months77 (49.3)
    Number of current ASMs
    One100 (38.6)
    Two94 (36.3)
    Three or more65 (25.1)
    ASM compliance
    Good228 (88.0)
    Poor31 (12.0)
    Frequency of missing ASM in poor complaint group (n=31)
    Almost daily13 (41.9)
    Weekly12 (38.7)
    Monthly6 (19.4)
    Previous Epilepsy surgery27 (10.4)
    History of ED visits due to breakthrough seizure126 (48.6)
    History of ICU admission due to SE47 (18.1)
    History of seizure-related trauma80 (31.1)
    • View popup
    Table 3

    - Relationship between fatigue and demographic factors.

    DemographicsFSSP-value
    No Fatigue (score: <4)Fatigue (score: ≥4)
    n (%)
    Sex
    Female74 (56.5)57 (43.5)0.002
    Male96 (75.0)32 (25.0)
    Age (year)
    ≤2015 (60.0)10 (40.0)0.418
    21–3078 (70.9)32 (29.1)
    31–4058 (60.4)38 (39.6)
    41–5017 (65.4)9 (34.6)
    >502 (100.0)0 (0.0)
    Handedness
    Left19 (70.4)8 (29.6)0.58
    Right151 (65.1)81 (34.9)
    Education level
    Below high school13 (54.2)11 (45.8)0.333
    High school58 (62.4)35 (37.6)
    Graduate94 (69.1)42 (30.9)
    Postgraduate5 (83.3)1 (16.7)
    Marital status
    Single83 (66.9)41 (33.1)0.116
    Married84 (66.7)42 (33.3)
    Divorced\widow3 (33.3)6 (66.7)
    Employed/studying:
    No65 (62.2)39 (37.5)0.384
    Yes105 (67.7)50 (32.3)
    Work timing
    Day time88 (67.7)42 (32.3)0.63
    Shifts (morning, evening, or night)16 (69.6)7 (30.4)

    *FSS=Fatigue severity scale

      • View popup
      Table 4

      - Prevalence of fatigue according to epilepsy characteristics.

      Epilepsy characteristicsFSSP-value
      No Fatigue (score: <4)Fatigue (score: ≥4)
       n (%) 
      Epilepsy classification
      Focal111 (64.2)62 (35.8)0.398
      Generalized49 (66.2)25 (33.8)
      Unclassified10 (83.3)2 (16.7)
      MRI
      Non-lesional91 (66.9)45 (33.1)0.65
      Lesional79 (64.2)44 (35.8)
      Seizure Control
      Uncontrolled89 (57.1)67 (42.9)<0.001
      Controlled81 (78.6)22 (21.4)
      Seizure frequency over the last 6 months in patients with uncontrolled seizure
      Daily7 (46.7)8 (53.3)0.61
      Weekly9 (40.9)13 (59.1)
      Monthly28 (66.7)14 (33.3)
      Once in 3–6 months45 (58.4)32 (41.6)
      Number of current ASMs
      One69 (69.0)31 (31.0)0.604
      Two61 (64.9)33 (35.1)
      Three or more40 (61.5)25 (38.5)
      ASM compliance
      Good152 (66.7)76 (33.3)0.344
      Poor18 (58.1)13 (41.9)
      Frequency of missing ASM in the poor complaint group
      Almost daily10 (77.0)3 (23.0)0.03
      Weekly5 (41.7)7 (58.3)
      Monthly3 (50.0)3 (50.0)
      Previous epilepsy surgery
      No149 (64.2)83 (35.8)0.16
      Yes21 (77.8)6 (22.2)
      History of ED visits due to breakthrough seizure
      No85 (63.9)48 (36.1)0.55
      Yes85 (67.5)41 (32.5)
      History of ICU admission due to SE
      No138 (65.1)74 (34.9)0.69
      Yes32 (68.1)15 (31.9)
      History of seizure-related trauma
      No120 (67)59 (33)0.48
      Yes50 (62.5)30 (37.5)
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    1 Oct 2025
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    Beyond Seizures: The hidden burden of fatigue in epilepsy
    Alia MR. Fallatah, Malak R. Albadrani, Sarah A. Alsalman, Weam K. Almasuad, Abdulrahim M. Hamhom, Sumayah M. Almarshedy, Faisal A. Alsallom, Fawzya A. Bamogaddam, Majed H. Alhameed, Mubarak M. Aldosari
    Neurosciences Journal Oct 2025, 30 (4) 278-285; DOI: 10.17712/nsj.2025.4.20250011

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    Beyond Seizures: The hidden burden of fatigue in epilepsy
    Alia MR. Fallatah, Malak R. Albadrani, Sarah A. Alsalman, Weam K. Almasuad, Abdulrahim M. Hamhom, Sumayah M. Almarshedy, Faisal A. Alsallom, Fawzya A. Bamogaddam, Majed H. Alhameed, Mubarak M. Aldosari
    Neurosciences Journal Oct 2025, 30 (4) 278-285; DOI: 10.17712/nsj.2025.4.20250011
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