الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Despite numerous medical treatment options developed over the years, drug-resistant epilepsy continues to be a challenging condition with poor social and economic consequences and represents a major handicap for the patient. We hypothesise that genetic variation involving SNCA1 which acts as a target for most of ASM and also plays a role in neuronal excitability, and genetic variation involving CCL2 which acts as a biomarker for inflammation and BBB disruption could help to understand the pathophysiology underlying drug resistant epilepsy. Patients and Methods: 35 patients with drug resistant epilepsy were enrolled in the study, along with 35 patients with drug controlled epilepsy. A group of 70 age and sex matched healthy individuals with negative past and family history of epilepsy and febrile convulsion were also included to be compared with the 2 epilepsy groups. After an informed consent, all participants underwent detailed history with identification of age of onset, duration of epilepsy, duration since last seizure, frequency and semiology of seizures. General and neurological examination was also done, psychiatric evaluation was also done using Hospital anxiety and depression scale (HADS). Radiological evaluation was also done for all subjects using magnetic resonance imaging (MRI) of the brain to identify any underlying cause for epilepsy and inter-ictal EEG was done for proper confirmation of the epilepsy type. Results: After logistic regression analysis, only increased seizure duration one year increases risk of drug resistant by 1.23, presence of mixed seizure type increases risk by 8.74 , presence of nocturnal seizures increases risk by 15.88, positive history of status epilepticus increases risk by 14.27 and presence of AA SNCA1SNP decreases risk by 0.568 to development of drug resistant epilepsy. Conclusion: Finally we can use SCN1A c.3184 A/G (rs2298771) and CCL2 (rs1024611) polymorphisms as genetic based biomarkers to predict pharmaco-resistance among epileptic patients. Key words: Drug Resistant Epilepsy; Clinical; Genetic.