Case-control Study Of Early Predictors Of Refractory Epilepsy

Objective: Early identification of people who are at high risk of developingrefractory epilepsy, and thus early to take measures such as clinical drug refractoryepilepsy application, even early surgical treatment, to interfere with or block itsdevelopment purpose of refractory epilepsy.Methods: The following data were obtained: gender, age, age at seizure onset,duration, family history of seizure disorders, perinatal events, history of febrile seizures,the response to antiepileptic drugs (AEDs) at early stage, the frequency of attacks inearly disease, and abnormal neuroimaging findings, abnormal neurologic status,intracranial infection, the phenomenon of clustering seizures, onset to standardizedtreatment time, EEG changes, seizure types, etiologic factors. Data were analyzed withchi-square test for trend for univariate comparison. Odds ratios (OR) and95%confidence interval(CI) were calculated. Forward logistic was used for multivariateanalysis.Results: Univariate analysis showed that age at onset≤3year, abnormalneuroimaging findings, abnormal neurologic status, intracranial infection, thephenomenon of clustering seizures, starting treatment after onset2years, symptomaticetiology, mixed seizure types, the interval of EEG focal or multifocal epileptiformdischarges, and high initial seizure frequency, poor response to therapy was associatedwith refractory epilepsy. Independent predictors of refractory epilepsy with regressionanalysis were: an inadequate response to therapy (OR30.607,95%CI5.284,177.278, P＜0.001), high initial seizure frequency (OR8.859,95%CI1.022,19.607, P=0.047), acluster attack characteristics (OR8.859,95%CI1.226,64.013, P=0.031), symptomaticepilepsy (OR5.388,95%CI1.083,26.802, P=0.04), mixed seizure types(OR2.12,95%CI1.115,4.03, P=0.022), abnormal neuroimaging findings (OR9.216,95%CI1.412, 60.135, P=0.02), the interval of EEG focal or multifocal epileptiform discharges(OR1.553,95%CI0.933,2.586, P=0.09), abnormal neurologic status(OR8.524,95%CI0.76,95.603, P=0.082), age at onset≤3year(OR2.393,95%CI0.914,6.267,P=0.076).Conclusions: Patients who have poor response to therapy, high initial seizurefrequency, cluster attack characteristics, symptomatic etiology, mixed seizure types,abnormal neuroimaging findings, the interval of EEG focal or multifocal epileptiformdischarges, abnormal neurologic status, age at onset≤3year were more likely todevelop refractory epilepsy.