Epilepsy at a University Hospital in Amman, Jordan

OBJECTIVE: To study the clinical, EEG, neuroimaging, treatment results and outcome in Jordanian patients observed in a tertiary care referral center and compare the findings with those from Western and Middle/Far Eastern literature.

METHODS: The case notes of 200 patients with epilepsy examined in an adult neurology clinic at Jordan University Hospital, Amman, Jordan, between January 2000 and December 2002 were reviewed. The findings of the EEG records and CT or MRI of the brain were registered. Seizures were classified according to the International League Against Epilepsy into generalized and partial seizures. The results of the treatment with antiepileptic drugs (AEDs) as well as the outcome were assessed.

RESULTS: Among the 200 patients reviewed, 119 were female and 81 were male, with a mean age of onset of 24.6 years, the majority (85%) were below 39 years. The main seizure types were generalized in 128 (64%) patients (92 patients with tonic clonic (TC) seizures) and partial in 72 patients. Interictal EEG was abnormal in 69% of the patients. Neuroimaging showed brain lesions in 33.5% of the patients with a higher yield in partial (56%) than in TC seizures (30%). Sodium valproate and carbamazepine were the most frequently and efficiently used AEDs for generalized and partial seizures. After a 3 year follow-up, 76% were fully controlled with AEDs, outcome being better in generalized than partial seizures (worst in complex partial seizures).

CONCLUSION: Compared to the previous population on hospital based reports from Western and Middle/Far Eastern literature, our study showed a higher proportion of females and generalized seizures and a relatively better outcome with relatively similar early age of onset, yield of investigations and treatment modalities.