Six clinical predictors for intractable childhood epilepsy

INTRODUCTION: This study aimed to determine the significance of six clinical predictors associated with medically intractable childhood epilepsy.
METHODS: Retrospective cohort study was conducted. A total of 241 children with diagnosed epilepsy were recruited and divided into two groups: 61 patients with intractable epilepsy, and the other 180 patients who responded well to antiepileptic drugs. We investigated seizure semiology, etiology of epileptic encephalopathy, EEG abnormalities and defined the odd ratios of predictor factors for intractable childhood epilepsy; (1) age of seizure onset, (2) asphyxia, (3) NICU history, (4) consanguineous marriage, (5) abnormal neuro-imaging, (6) neuropathologic exam, (7) prematurity, (8) parents seizure history.
RESULTS: According to logistic regression analysis major risk factors for intractable childhood epilepsy are (1) neuropathologic examination P=0.000, odds ratio OR=58.28 95% confidence interval CI=23.95-141.63; (2) abnormal neuro-imaging P=0.000, OR=37.55 CI=16.41-85.94 (3) age of seizure onset P=0.001, OR=9.43 CI=3.66-24.3 (4) asphyxia P=0.001 OR=4.16 CI=1.75-9.87 (5) consanguineous marriage P=0.001 OR=3.02 CI=1.53-5.97 (6) NICU history P=0.003 OR=2.59 CI=1.38-4.87.
DISCUSSION AND CONCLUSION: Presented six predictors can be used to define the medical intractability in children with epilepsy to provide early alternative treatment protocol for better seizure control and quality of life.