Abstract Details

Title Incidence of Anti-Epileptic Drug Related Falls

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P15 - Poster Session 15 (12:00 PM-1:00 PM)

Poster/Presentation
Number 12-007

Objective

Describe the rate of falls across different antiepileptic drugs (AEDs).

Background

According to Center for Disease Control, 30 million seniors fall each year-resulting in 30,000 deaths. Risk of falls is a burden to people with epilepsy (PWE) [1]. AEDs may cause dizziness, ataxia, peripheral neuropathy, and low bone density, leading to falls or further morbidity. Few studies have explored the relationship between specific AEDs and risk of falls [2,3].

Design/Methods A retrospective analysis was conducted of PWE prescribed AEDs to capture reported falls and their causes. Consecutive charts of seizure clinic visits were reviewed as part of the Yale Antiepileptic Drug Database Project. Falls were then identified by patient report and corresponding physician documentation in the chart. We calculated number of falls per number of unique prescriptions per patient.

Results 1344 PWE and 3411 prescriptions were included. The proportion of AED-attributed falls (and corresponding number of patients on the medications), listing per 1000 prescriptions, include: oxcarbazepine (n=305), 33 falls per 1000 prescriptions; clobazam (n=365), 27; eslicarbazepine (n=64), 15.6; carbamazepine (n= 568), 10.6; lamotrigine (n=651), 9.2; phenytoin (n=550), 9.1; phenobarbital (n=296), and 3.4; valproic acid (n=556), 3.6. Additionally, vagus nerve stimulation (n=56) was associated with 17.9 falls per 1000 surgeries. As a group, sodium channel blockers (n=2138) were associated with a larger proportion of falls (77 per 1000 prescriptions) compared to other treatments (n= 1273; 51.9 falls per 1000 prescriptions).

Conclusions On univariate analysis, people with epilepsy treated with sodium channel blocking AEDs have a higher rate of falls in comparison to those treated with other treatments. We are currently in the process of extracting data to evaluate for confounders, perform multivariate analysis, review the cause of falls, and compare rates of injuries from falls including fractures

Authors/Disclosures
PRESENTER	No disclosure on file
Ebony Jackson-Shaheed	No disclosure on file
Lawrence J. Hirsch, MD, F�鶹��ýӳ�� (Yale University Comprehensive Epilepsy Center)	Dr. Hirsch has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Ceribell. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for marinus. The institution of Dr. Hirsch has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Natus. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurelis. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Rapport Therapeutics. Dr. Hirsch has received publishing royalties from a publication relating to health care. Dr. Hirsch has received publishing royalties from a publication relating to health care. Dr. Hirsch has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker; Faculty for Fellows' training course with Neuropace. Dr. Hirsch has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Natus.
Hamada H. Altalib, DO (VA Connecticut Healthcare System)	The institution of Dr. Altalib has received research support from UCB. The institution of Dr. Altalib has received research support from DEPARTMENT OF DEFENSE - CONGRESSIONALLY DIRECTED MEDICAL RESEARCH PROGRAMS.

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