PREDICTORS OF DRUG RESISTANT EPILEPSY IN CHILDREN: A CLINICAL , ELECTROENCEPHALOGRAPHIC AND NEUROIMAGING STUDY

Abstract

Background and aim of the study: Refractory epilepsy is usually defined as failure to achieve seizure freedom
for 12 months or more, for whatever reason .This study aims to determine various epidemiologic and clinical
factors, electroencephalographic changes, and neuroimaging abnormalities associated with medically intractable
seizures in children . Subjects and methods: 150 epileptic patients were included in the study aged 18 months
to 13 years; sixty patients were considered to be intractable to treatment while the remaining ninty patients were
controlled epileptic children. The collected data from patients included personal history, presence of neurological
deficits, age of seizure onset, number of seizure attacks before initiation of therapy, previous occurrence of status
epilepticus, type of seizures ,presence of infantile spasms and developmental state. All the patients had
performed EEG.All patients had performed magnetic resonant brain imaging either as a part of the study or due
to any cause within their routine care. Results: There was a significant intractability to therapy in patients with
developmental delay, associated neurological deficits, early onset of seizures, partial seizure type, infantile
spasms , microcephaly , MRI abnormality and focal EEG abnormality. MRI revealed brain atrophic changes to
be the most common lesion associated with intractable seizures. EEG revealed that focal epileptogenic activity
was the most common abnormality associated with intractable seizures .Conclusion: Neurological deficits, early
onset seizures , microcephaly , developmental delay ,infantile spasm , abnormal MRI and focal EEG
abnormalities are important predictors of intractable epilepsy.