ABSTRACT

Objective: Childhood intractable epilepsy is a serious condition with catastrophic effects in neurodevelopment. Although there are numerous studies regarding which epileptic patients will develop intractable epilepsy, there is no clear data yet. In this study, it was aimed to investigate predictors affecting intractability in children with symptomatic epilepsy.

Material and Methods: In this study, we retrospectively reviewed data of 75 patients whose seizures still continue despite treatment with at least two antiepileptic drugs and who had been followed for at least one year in the Pediatric Neurology Clinic of Çukurova University Faculty of Medicine, Pediatric Neurology Department Hospital and investigated risk factors determining intractability in childhood epilepsy by dividing the patients into three groups. Group 1 included patients who had at least one seizure in the last six months despite taking at least two antiepileptic drugs, Group 2 included patients who had less than one seizure in the last six months despite taking at least two antiepileptic drugs, and Group 3 included patients with symptomatic epilepsy, who used at least two antiepileptic drugs in proper dosages and did not have any seizures for the past one year.

Results: While the most important risk factor in intractable epilepsy development was found as status epilepticus (SE) (p< 0.05), the age of onset of seizures, presence of mental retardation, presence of a neurologic abnormality, epileptic activity in EEG and presence of neuroradiologic abnormality, consanguinity, epilepsy history in the family, presence of neonatal seizure, febrile convulsion, and seizure incidence before starting drugs were not found to be significant (p> 0.05).

Conclusion: In this study, it was concluded that history of status epilepticus was an important and independent risk factor for intractable epilepsy development. During medical follow-up of epileptic patients and patients with risk factors, it is required to start rational drug use early and apply necessary interventions before the patients before the status at the onset of seizure.

Keywords: Epilepsy, intractable factors