Six Clinical Predictors for Intractable Childhood Epilepsy

Ayça, Senem; Oral, Ramazan Deniz; Dündar, Pınar Erbay; Polat, Muzaffer

doi:10.4274/jpr.galenos.2019.93276

Cited by 2 publications

(3 citation statements)

References 18 publications

(23 reference statements)

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“…In the present study, a positive family history of seizures was not identified as a predictor of drug resistance. This is consistent with Ayca and colleagues [ 11 ], who showed that a positive family history of seizures did not seem to be a risk factor for drug-resistant epilepsy. Other studies found no significant correlation between a family history of seizures and drug-resistant epilepsy [ 10 , 12 , 13 ].…”

Section: Discussionsupporting

confidence: 92%

“…The association between developmental delay and negative outcomes may result from minor but widespread brain anatomical abnormalities [ 10 ]. Hypoxic or asphyxic events, mainly in the perinatal period, promote epileptogenesis and are important in developing drug resistance [ 11 ]…”

Section: Discussionmentioning

confidence: 99%

“…In addition, previous studies also showed that neurological impairment could alone predict drug resistance [ 16 ]. Ayca and colleagues [ 11 ] also found that abnormal neurological examination was 58 times more in drug-resistant epilepsy and was the most important risk factor, possibly reflecting the severity of brain damage. The presence of abnormal neurological examination agrees with other studies [ 10 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

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Clinical, radiological and electrophysiological predictors for drug-resistant epilepsy

Abokrysha

Taha

Shamloul

et al. 2023

Egypt J Neurol Psychiatry Neurosurg

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Background Epilepsy is the third chronic brain illness worldwide. About a third of the epileptic patients will be drug resistant. Early identification of these patients is critical for appropriate treatment selection and prevention of the devastating consequences of recurrent seizures. The objective of this study aims to detect clinical, electrophysiological, and radiological predictors for drug-resistant epilepsy patients. Results One hundred fifty-five patients were included in this study, divided into a well-controlled epilepsy group (103 patients) and a drug-resistant group (52 patients). Both groups were compared regarding clinical, electrophysiological, and neuro-radiological data. Younger age at onset, history of delayed milestones, history of perinatal insult (especially hypoxia), mental retardation, neurological deficits, depression, status epilepticus (SE), complex febrile seizures, focal seizure to bilateral tonic–clonic convulsion as well as multiple seizures and high seizure frequency (daily) at onset, poor response to first anti-seizure drug (ASD), structural and metabolic etiology, abnormal brain imaging, and slow background and multifocal epileptiform discharges in EEG were significant risk factors for the development of drug-resistant epilepsy. Conclusion MRI abnormalities are the most significant predictor for drug-resistant epilepsy. Drug-resistant epilepsy is associated with clinical, electrophysiological, and radiological risk factors that can be used to diagnose drug-resistant patients early and choose the best treatment option and time.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical, radiological and electrophysiological predictors for drug-resistant epilepsy

Abokrysha

Taha

Shamloul

et al. 2023

Egypt J Neurol Psychiatry Neurosurg

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Drug resistance predictive utility of age of onset and cortical imaging abnormalities in epilepsy: a systematic review and meta-analysis

Alare,

Ogungbemi,

Fagbenro

et al. 2024

Egypt J Neurol Psychiatry Neurosurg

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Background Drug resistance has been a global burden in the management of epilepsy. It is desirable if this could be predicted earlier in the course of management to give time for alternative and a more definitive mode of management, such as epilepsy surgeries. Methods We conducted a systematic review and meta-analysis to investigate the relationship between elevated age at the onset of the first seizure or cortical imaging abnormalities and the development of drug resistance in epilepsy. We performed a systematic search in PubMed, EMBASE, and SCOPUS databases for studies investigating the predictive utility of age of onset or cortical imaging abnormalities on drug resistance. Results Odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were extracted and analyzed by the RevMan 5.4 software. Meta-analysis was done across 12 studies involving 5315 patients. Age of onset of seizures younger than 5 years was found to be associated with the development of drug resistance (OR: 0.685, 95% CI 0.410–0.960), also cortical imaging abnormalities were found to be associated with the development of drug resistance. Conclusion Children with early onset seizures could better from neurosurgical management than pharmacological management as the early age of onset was associated with drug resistance and cortical abnormalities on neuroimaging could be an indication for neurosurgical management of epilepsies.

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Six Clinical Predictors for Intractable Childhood Epilepsy

Cited by 2 publications

References 18 publications

Clinical, radiological and electrophysiological predictors for drug-resistant epilepsy

Clinical, radiological and electrophysiological predictors for drug-resistant epilepsy

Drug resistance predictive utility of age of onset and cortical imaging abnormalities in epilepsy: a systematic review and meta-analysis

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