Analysis of clinical predictors of intractable childhood epilepsy

Abstract

Objective To identify clinical predictive factors in intractable childhood epilepsy, to provide some evidence for its early diagnosis. Methods Six hundred and twenty-four children with newly diagnosed epilepsy were retrospectively identified in Xinhua Hospital Affiliated to Shanghai Jiaotong University Medical School(1993-2009). The epileptic children were divided into a drug-responsive epilepsy group(n=584) and an intractable epilepsy group(n=40). Clinical data of patients were retrospectively analyzed, including the gender, age, pathogen, inducement, number of pre-treatment seizures, seizure type, seizure type change, seizure duration, family history, previous history, physical examination, brain CT and initial electroencephalogram(EEG) findings.Single factor analysis and Logistic regression analysis were made in 2 groups. Results Strong univariate associations suggested that some factors could increase the risks of intractable epilepsy: symptomatic or cryptogenic epilepsy, mental retardation, type of infantile spasm, positive neurological examination and large absolute number of pre-treatment seizures, and changes in seizure types in the course of the disease.With multiple Logistic regression, independent predictors of intractability were symptomatic or cryptogenic etiology(OR=3.61), large absolute number of pre-treatment seizures and changes in seizure types in the course of the disease(OR=4.76). Conclusions It's necessary to be wary of intractable epilepsy and to adjust therapy accordingly when seizures were uncontrollable and accompanied by one or more conditions such as symptomatic or cryptogenic epilepsy, large absolute number of pre-treatment seizures, changes in seizure types in the course of the disease. Key words: Child; Intractable epilepsy; Predictors