Title : Drug and alcohol abuse in patients with intractable epilepsy
Abstract:
Seizures often occur in substance abusers. The mechanism may be indirect as a result of infection. Due to the ever-increasing problem of drug abuse among young people and adolescents, the involvement of a drug should be suspected whenever there is a temporal relationship between the use of the drug and the onset of a neurological syndrome and when the other known risk factors have been excluded. However, since addicts often use mixtures of drugs and do not give an honest report of their usage, it is difficult to assess the role of an individual drug. The objective of the present work is to study the etiology of non-response to antiepileptic drugs by estimating their serum levels and screening of drugs and substance abuse in patients with resistant epilepsy. This study was conducted in epilepsy outpatient clinic. 924 patients with intractable epilepsy were included. They subjected to toxicology screen for detection of drug and substances abuse by analysis of urine and blood samples. Measurements of the level of antiepileptic drugs in the blood (carbamazepine, valproic acid, phenytoin). All assays run on the system use of homogenous immunoassay technique EMIT (Enzyme Multiplied Immunoassay Test) and confirmed by GC/MS (gas Chromatography/Mass Spectrum). Positive results for drug and substance abuse were found in 246 of 924 patients (26.62%). Substances abuse may be the cause of resistant epilepsy as they are epileptogenic by themselves or due to drug-drug interaction with the antiepileptic.
