Factors associated with drug-resistant epilepsy in adults from Southern Kazakhstan

INTRODUCTION: The prevalence of drug-resistant epilepsy (DRE) among epilepsy patients has not decreased despite better diagnostic methods and treatment options because it affects approximately one-third of all epilepsy patients. The research aims to identify which clinical patterns and social characteristics contribute to drug resistance. METHODS: This retrospective analytical cross-sectional study included 300 patients with epilepsy in Southern Kazakhstan. The participants received their drug resistance status through ILAE criteria, which classified them into drug-sensitive (DSE) or drug-resistant groups. Patient data was studied through clinical and socio-demographic evaluations, EEG and MRI assessments, and MoCA cognitive performance tests. RESULTS: The research discovered drug-resistant epilepsy in 37% of participants. The DRE patients were 35 ± 12 years old at the time of study, while DSE patients were 39 ± 15 years old (p = 0.023). The development of DRE became more likely when patients experienced their first seizure at a young age and when they had multiple seizures throughout the day (p < 0.01). The presence of MRI abnormalities increased the risk of drug resistance by 2.42 times (95% CI: 1.3-4.23) when compared to drug-sensitive epilepsy patients (p = 0.002). CONCLUSION: The study revealed that early seizure onset, prolonged duration, severe seizures, brain imaging abnormalities, and lower cognitive performance are related to DRE.