Predictor factors of intractable childhood epilepsy: A Turkish study

Objective: This study aimed to determine the clinical, electroencephalographic, and radiological factors associated with medically intractable seizures in children. Methods: Retrospective cohort study was conducted. A total of 241 children with diagnosed epilepsy were recruited and divided into two groups: 61 patients with drug resistant, and the other 180 patients without drug resistant. We studied the predictor factors of intractability. Results: 21 patients had epileptic encephalopathy in the drug resistant group (%45.9). Twelve patients in the drug resistant group had diagnosis of west syndrome, 4 patients had Lenaux Gastaut syndrome, 3 patients had Dravet syndrome, 5 patients had electrical status epilepticus of sleep (ESES), 2 patients had Landau Kleffner syndrome and 2 patients had Doose syndrome. Structural and metabolic disorders (% 34.6) were the most seen neuroimaging abnormallity in the drug resistant group. Focal/multifocal pattern in EEG (%37.7) and parsiel seizure type (%42.6) were seen predominantly in the group with drug resistant. Conclusion: Onset <1 year of age, etiology of epileptic encephalopathy, abnormal neurodevelopmental status, EEG and neuroimaging abnormality, history of prematurity history of asphyxia, family history of intermarriage were predictive factors of intractability. In follow up epileptic children we should interrogate these factors and close monitoring should be done in case of predictive factors presenting; different treatment options should keep on mind.