Clinical Use Of The 2010 International League Against Epilepsy’s Definition Of Drug-resistant Epilepsy And Analysis Of Its Risk Factors

Objective:To evaluate the clinical use of the 2010 International League Against Epilepsy’s definition of drug-resistant epilepsy and to identify the risk factors of drug-resistant epilepsy.Methods: A follow-up study was conducted involving 230 patients who were attended at the Epilepsy Outpatient Clinic of the Second Affiliated Hospital of Soochow University during March 2013 to July 2014. According to the definition, outcomes of antiepileptic drugs were categorized. We explored the effect of higher dosage to 50%DDD first if an antiepileptic drug(AED) failed. Statistical analysis were carried out using SPSS 18.0 by multivariate logistic regression to find the risk factors of drug-resistant epilepsy.Results:Of the 230 patients analysed, 106(46.1%) were drug-resistant epilepsy, 66(28.7%) obtained seizure freedom, 58(25.2%) were classified as undetermined. The statistically significant factors associated to drug-resistant that were found in our population were: MRI evidence of structural cerebral abnormality(OR=2.214,95%CI:1.011~4.851,P=0.047),frequency of epilepsy more than 10 seizures before treatment(OR=4.856,95%CI:2.214~10.649,P<0.0001)and abnormal epilepsy-like EEG wave after treatment(OR=3.500,95%CI:1.618~7.571,P=0.001).Conclusion:Uncontrolled epilepsy is not equal to drug-resistant epilepsy and can be seizure-free through raising dosage of AEDs. Patients who have MRI evidence of structural cerebral abnormality, have higher frequency attack before treatment and abnormal epilepsy-like EEG wave after treatment tend to develop into drug-resistant epilepsy.