Predictive Factors of Refractory Epilepsy

Abstract

Background: Several epileptic patients give no response to the usual line of treatment, which represents 1/5 of epileptic patients and is  known as drug-resistant epilepsy (DRE). DRE is often accompanied by impaired intellectual functions, psychiatric co-morbidities, physical  damage, and low quality of life (QoL).

Objective: This study aimed to assess the predictive factors for early identification of refractory  seizures.

Patients and Methods: This was a cross-section study conducted during a period of one year at Emergency Department (ED),  Faculty of Medicine, Mansoura University. We comprised cases with diagnosis of refractory epilepsy on a total of 80 patients with  refractory seizures [at least 2 potentially effective anti-epileptic drugs (AEDs) whatever mono or combined in maximally tolerated dose].

Results: Of the studied cases, 62.5% were females. There was a significant difference in cases with refractory epilepsy as regard seizures  types with higher frequency of mixed and focal seizures. There was no statistically significant difference recorded regarding the previous  history of status epilepticus (SE). Mixed seizures were significantly increased among cases with refractory epilepsy. The presence of  positive family history, positive history of febrile seizures, associated psychiatric disorders and younger age at disease onset increase risk  of refractory epilepsy.

Conclusion: The main predictors of development of DRE were high initial seizures frequency, positive family  history, febrile seizures, associated psychiatric disorders and younger age at disease onset.