Early clinical predictors of intractable epilepsy in childhood

In this retrospective study, we evaluated the clinical responses to antiepileptic drug (AED) therapy in pediatric epilepsy patients treated at a single center. Materials and methods: We identified 28 children with intractable epilepsy and 213 patients with drug-responsive epilepsy. Results: Univariate analysis showed that age at onset, high (daily) initial seizure frequency, infantile spasm, history of neonatal seizures, abnormal neurodevelopmental status, neurological abnormalities, mental retardation, remote symptomatic etiology, and abnormal brain imaging results were significant risk factors for the development of intractable epilepsy (P < 0.05). Multivariate logistic regression analysis revealed that high (daily) initial seizure frequency and remote symptomatic etiology were significant and independent risk factors for intractable epilepsy (P < 0.05). Conclusion: Our study suggests that the risk of developing intractable epilepsy in childhood may be predicted, to some extent, by the early clinical course. Early identification of patients at high risk of developing intractable epilepsy will guide appropriate therapy and reduce exposure to ineffectual treatments.

Anahtar Kelimeler:

Key words: Intractable epilepsy, childhood

Early clinical predictors of intractable epilepsy in childhood

Keywords:

Key words: Intractable epilepsy, childhood,

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Oskoui M, Webster RI, Zhang X, Shevell MI. Factors predictive of outcome in childhood epilepsy. J Child Neurol 2005; 20: 898–904.
Gururaj A, Sztriha L, Hertecant J, Eapen V. Clinical predictors of intractable childhood epilepsy. J Psychosom Res 2006; 61: 343–7.
Altunbasak S, Herguner O, Burgut HR. Risk factors predicting refractoriness in epileptic children with partial seizures. J Child Neurol 2007; 22: 195–9.
Seker Yilmaz B, Okuyaz C, Komur M. Predictors of intractable childhood epilepsy. Pediatr Neurol 2013; 48: 52–5.
Commission on Classification and Terminology of the International League Against Epilepsy (ILAE). Proposal for revised classification of epilepsy and epileptic syndromes. Epilepsia 1989; 30: 389–99.
Commission on Epidemiology and Prognosis of the International League Against Epilepsy. Guidelines for epidemiological studies on epilepsy. Epilepsia 1993; 34: 592–6.
Sillanpaa M. Remission of seizures and predictors of intractability in long-term follow-up. Epilepsia 1993; 34: 930–6.
Çalişir N, Bora I, Irgil E, Boz M. Prevalence of epilepsy in Bursa city center, an urban area of Turkey. Epilepsia 2006; 47: 1691–9.
Kwong KL, Sung WY, Wong SN, So KT. Early predictors of medical intractability in childhood epilepsy. Pediatr Neurol 2003; 29: 46–52.
Chawla S, Aneja S, Kashyap R, Mallika V. Etiology and clinical predictors of intractable epilepsy. Pediatr Neurol 2002; 27: 186–91.
Berg AT, Shinnar S, Levy SR, Testa FM, Smith-Rapaport S, Beckerman B. Early development of intractable epilepsy in children: a prospective study. Neurology 2001; 56: 1445–52.
Camfield C, Camfield P, Gordon K, Smith B, Dooley J. Outcome of childhood epilepsy. A population- based study with a simple scoring system for those treated with medication. J Pediatr 1993; 122: 861–8.
Eriksson KJ, Koivicco MJ. Prevalence, classification and severity of epilepsy and epileptic syndrome in children. Epilepsia 1997; 38: 1275–82.
Berg AT, Levy SR, Novotny EJ, Shinnar S. Predictors of intractable epilepsy in childhood: a case-control study. Epilepsia 1996; 37: 24–30.