الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Epilepsy is the third most common chronic brain disorder. About one third of all epileptic patients will be drug resistant. Early identification of these patients is critical for appropriate treatment selection and prevention of devastating consequences of recurrent seizures.Objectives: This study aimed to estimate Clinical, Neurophysiological, and Radiological finding among refractory patient in Epilepsy outpatient clinic, Kasr Alainy hospital in Egypt that could be used as predictor for early detection of refractory epilepsy. Subjects And Methods: A case{u2013}control study was conducted at Epilepsy outpatient clinic ,Kasr Alainy hospital in Egypt, including 155 patients with epilepsy, divided into two groups: refractory group (52) and well controlled epilepsy group (103).A comparison between both groups was done regarding clinical, Electrophysiological, and neuro-radiological data. Multiple stepwise logistic regressions were conducted to find the significant predictors for refractory epilepsy. Results: Univariate analysis showed that a younger age at onset (below 12years), history of delayed mile stones, history of perinatal insult (especially hypoxia), Status epilepticus, complex febrile, type of seizure at onset(Focal seizure to bilateral tonic clonic convulsion as well as multiple seizures), high seizure frequency (daily) at onset and poor response to first ASD, mental retardation, neurological deficits and psychiatric manifestations (especially depression),epilepsy etiology (structural and metabolic), abnormal EEG finding (slow background and multifocal epileptiform discharges), abnormal brain imaging (brain atrophy, temporal sclerosis, cortical dysplasia) were significant risk factors for the development of refractory epilepsy (P value {u2264}0.001). Multivariate logistic regression analysis showed that cognitive and neurological comorbidities and MRI abnormality were significant and independent risk factors for refractory epilepsy (B 4.1, 1.9 and 3.1 respectively) |