Early identification of risk factors for development of refractory epilepsy

Background Epilepsy is the most common neurological disorder, Epilepsy result from diverse etiologies, including structural brain lesions, as well as monogenic and polygenic variation. The importance of timely identification of refractoriness, it is crucial to prioritize the detection of this condition before considering alternative treatments like surgery .Objective: To determine risk factors for development of refractory epilepsy among children and adolescents with epilepsy in Pediatric Neurology Clinic of Benha University Hospitals. Methods: This study was prospective cohort study. We studied 125 children aged 1 day-18 years who were diagnosed with epilepsy. For each patient, age, gender, full clinical examination were noted. Study sample included 125 patients ,patients were divided into two groups .Patients who were responsive nominated as control (48 patients) , patients were considered to be seizure-free if they had not had any seizures for at least one year. While patients who were resistant nominated as cases (77 patients) who failed adequate trials of 2 tolerated and appropriately chosen and used anti-epileptic drugs schedule . Results: History of developmental delay and age of onset of seizure below one year were significantly higher among patients with refractory epilepsy than those with responsive epilepsy. Structural brain changes and abnormal neuroimaging were more prevalent in refractory epilepsy group than responsive group. Conclusion: Our study revealed the most important independent predictors of refractoriness were: age of onset below one year, presence of structural brain changes, abnormal neuroimaging and history of developmental delay