Focal drug-resistant epilepsy: Progress in care and barriers, a Morroccan perspective

Abstract

Introduction: The aim of this study is to determine the clinical, paraclinical, therapeutic and outcome aspects of drug resistant patients with epilepsy in our region and consequently to discuss methods that may improve the management of these patients. Patients and methods: This paper presents a retrospective study of 25 adult patients that were followed for focal drug resistant epilepsy in epileptology unit of the University Hospital of Fez, Morocco. Results: This study recorded 25 patients including 48% of males and 52% of females. The mean age of patients was 24years-old. Hippocampal sclerosis was present in 28.5% of patients (7 cases); brain malformations were found in 19% of patients (5 cases); tumors were found in 24% of patients (6 cases); post-traumatic, post-surgical and anoxic-ischemic lesions were found in 28.5% of patients (7 cases). Resective epilepsy surgery was performed in 28,5% of patients (7 cases). Post surgical outcome was good for 5/7 patients (Engel I and II). Conclusion: The clinical characteristics, etiologies and clinical course of medically refractory focal epilepsy in our region are similar to that reported in the global literature. We also demonstrated a long delay between onset of seizures and surgery (15years range 8–34years) and barriers to epilepsy surgery.