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Volume 09
Journal of Alzheimers Disease & Parkinsonism
ISSN: 2161-0460
Epilepsy 2019
Parkinsons Congress 2019
August 29-31, 2019
JOINT EVENT
conferenceseries
.com
August 29-31, 2019 Vienna, Austria
&
5
th
International Conference on
Epilepsy & Treatment
5
th
World Congress on
Parkinsons & Huntington Disease
Drug and substance abuse in refractory epilepsy
Abdeldayem Raafat
and
Hazem Maha
Mansoura University, Egypt
Background:
Seizures often occur in substance abusers. The present work aimed 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.
Methods:
This study was conducted in epilepsy outpatient clinic, neurology department, Mansoura University
Hospital. After exclusion those with organic brain lesion and who not compliant to antiepileptic treatment, 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).
Results:
Confirmed Positive results for drugs and substances abuse were detected in 246 of 924 patients (26.62%)
by GC/MS. Cannabis was the first abused drug (29.27%), opiates was the second drug abused by patients (21.95%)
followed by alcohol (17.88%), benzodiazepine (16.26%) tricyclic antidepressants (8.54%) and finally barbiturate
constituted (6.1%). Only 17 patients show serum level of antiepileptic drugs (carbamazepine, valproate and
phenytoin) within therapeutic range, but 169 patients' levels were below it and 60 patients with levels above it.
Conclusions:
Substances abuse may be the cause of resistant epilepsy as they are epileptogenic by themselves or due
to drug-drug interaction with the antiepileptic.
Recommendations:
A screening test for drug and substances abuse performed if drug abuse or withdrawal suspected
in patients with resistant epilepsy even if patients deny the use of them. To confirm the results of EMIT, further study
is needed by using GCMS (gas chromatography mass spectrum) as it is more sensitive and more specific than EMIT
system.
J Alzheimers Dis Parkinsonism 2019, Volume 09