The Etiology Analysis Of Symptomatic Epilepsy In Western China Patients

Objective: The aim of this study was to investigate and analyze the etiology of symptomatic epilepsy in Western China patients, and its distribution feature among different age groups. Methods: Analysis was performed on patients who were diagnosed with symptomatic epilepsy during out- and inpatient services of several tertiary epilepsy centers(The Sichuan province people’s hospital,West China Hospital of Sichuan University, first affiliated hospital of Chongqing medical University and so on) in Western China from July 2010 to July 2015. We investigated the demographic data, etiology and imaging data. Results: 1. In our study, Total 7599 patients diagnosed with epilepsy were enrolled, and 2658 patients(35.0%) were diagnosed with symptomatic epilepsy. Idiopathic epilepsy,essential epilepsy were 16.7%, 48.7%, respectively. 2. In 2658 patients enrolled with symptomatic epilepsy, 1678 patients(63.1%) were male, while 980 patients(36.9%) were female. The ratio of male to female was 1.71:1. 3. According to the percentage of symptomatic epilepsy in all epilepsy patients, male was higher than female. The mean age was 30.04±20.90 years old. The average onset age of seizure was 27.63±21.55 years old(range from 1 month to 96 years old). Most of them were teenagers under the age of 20, in 47.7%. Symptomatic epilepsy was in 30.9% of all epilepsy patients during 0 to 9 years old, while the proportion dropped to 25.2% in 10-19 years old group. Presents was increased in following age groups. In 70 years and older group, the percentage of symptomatic epilepsy was up to 89.9%. 4. Partial onset seizures was the most common type of symptomatic epilepsy(55.5%), while the proportion of generalized-onset seizures, epilepsy syndrome and unclassified were 24.4%, 0.3% and 12.7%, respectively. 5.The most common etiology of symptomatic epilepsy was traumatic brain injury(617 cases) in western China,occupying 23.2% of the whole symptomatic epilepsy patients, followed by intracranial infection in 401 cases(15.1%), stroke in 397 cases(14.9%), additional disease of febrile convulsion in 315 cases(11.9%), perinatal injury in 273 cases(10.3%) and 226 cases(8.5%) with more than one cause. The most common causes of male patients were traumatic brain injury in 445 cases(26.5%), stroke in 277 cases(16.5%), intracranial infection in 246 cases(14.7%), additional disease of febrile convulsion in 172 cases(10.3%), perinatal injury in 154 cases(9.2%), brain tumor in 136 cases(8.1%) and 128 cases(7.6%) with more than one cause. And among women, the leading cause was traumatic brain injury in 172 cases(17.6 %), followed by intracranial infection in 155 cases(15.8%), additional disease of febrile convulsion in 143 cases(14.6%), stroke in 120 cases(12.2%), perinatal injury in 119 cases(12.1%), and 98 cases(10.0%)with more than one cause. 6.The distribution of causes in male and female patients was significant different, including the cause of traumatic brain injury, stroke, additional disease of febrile convulsion, perinatal injury, and with more than one cause. With the proportion of brain injury and stroke, male was much higher than women, while the proportions of febrile convulsion additional disease and perinatal injuries in female were significantly higher than those in male patients. The most common cause and its ratio in different age groups, 0-9, 10-19, 20-29, 30-39, 40-49, 50-59, 60-69 and ≥70 was perinatal injury(30.9%), traumatic brain injury(29.7%), traumatic brain injury(42.5%), traumatic brain injury(31.2%), traumatic brain injury(20.4%), stroke(36.3%), stroke(46.2%), stroke(67%), stroke(76.9%), respectively. 7. Course of the disease for more than 10 years, 5 to 10 years, within five years had shown significant different feature in etiology. Course of the disease in more than 10 years of patients,intracranial infection, brain tumors were more than the other two course section, while perinatal injuries was more in 5 to 10 years. And stroke was more in five years and 5-10 years. Conclusion: 1. Symptomatic epilepsy accounted for 35.0% of all epilepsy in western China. Idiopathic epilepsy,essential epilepsy and unknown were 16.7%, 33.1% and 15.6%, respectively. And the most common seizure type was partial onset seizures. 2. The leading causes of symptomatic epilepsy were traumatic brain injury(23.3%), intracranial infection(15.1%), and stroke(14.9%). Traumatic brain injury being the most common cause related to population mobility and region. 3. According to the percentage of symptomatic epilepsy in all epilepsy patients, male was higher than female. With the proportion of brain injury and stroke, male was much higher than women, while the proportions of febrile convulsion additional disease and perinatal injuries in female were significantly higher than those in male patients. This may be related to motorcycles was the most common used vehicles by men and men always worked in construction in western China. 4. The percentage of symptomatic epilepsy was 30.9% in children aged 0 to 9, and 25.2 in patients with 10 to 19 years old yours. After the age of 20, with the increasing of age, the proportion of symptomatic epilepsy was increased. The leading etiology was perinatal injuries in patients aged 0 to 9,while in the older than 60 years old group was stoke. 5. Course of the disease for more than 10 years, 5 to 10 years, within five years had shown significant different feature in etiology. Course of the disease in more than 10 years of patients,intracranial infection, brain tumors were more than the other two course section, while perinatal injuries was more in 5 to 10 years. And stroke was more in five years and 5-10 years.