Last modified: 2018-09-09
Abstract
Introduction:
Drug resistant epilepsy (DRE) which is 10 to 30% of all epileptics is major health problem in children suffering from epilepsy.
Despite newer anti-epileptics, the seizure control has not improved dramatically.
Objective:
To study Clinical Profile and electrophysiological and radiological findings of DRE.
Methods:
The study was conducted at Dr. D. Y. Patil Medical college and Hospital Pimpri Pune after institutional ethical committee approval.
All patients fulfilling the criteria for DRE visiting the OPD and IPD in 2017 were enrolled in the study after informed signed consent.
Results:
Of 32 enrolled patients, 66% were male.
44% were in 3-5 years.
Average age from onset of seizures to refractoriness was 1.97 years.
Commonest seizure was GTCS (69%), Focal (53%) and myoclonic jerks (38%)
9% were preterm and had antenatal complications.
18% patients were born by LSCS of which 50% didn’t cry immediately after birth.
47% had developmental delay.
% of Patients on 5, 4 & 3 anti-epileptic drugs were 6 %,31 %, & 59% respectively.
EEG showed epileptic encephalopathy (22%), focal abnormalities (41%), frequent generalised epileptiform activity (31%) multifocal IEDs (16%).
MRI showed congenital brain malformations (9%), hypoglycaemic brain injury (6%), Diffuse brain atrophy and focal abnormalities in 16% each.
47% patients had normal MRI.
Conclusion:
DRE usually become refractory in first 2 years from onset.
Patients with antenatal, natal or postnatal complication were at higher risk of DRE.
All patients with focal seizures had focal abnormalities on EEG and MRI