American Journal of Clinical Medicine Research
ISSN (Print): 2328-4005 ISSN (Online): 2328-403X Website: http://www.sciepub.com/journal/ajcmr Editor-in-chief: Dario Galante
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American Journal of Clinical Medicine Research. 2014, 2(1), 26-31
DOI: 10.12691/ajcmr-2-1-7
Open AccessArticle

Predictors and Typical Clinical Findings of Refractory Epilepsy

E. Viteva1,

1Department of Neurology, University of Medicine, Plovdiv, Bulgaria

Pub. Date: February 07, 2014

Cite this paper:
E. Viteva. Predictors and Typical Clinical Findings of Refractory Epilepsy. American Journal of Clinical Medicine Research. 2014; 2(1):26-31. doi: 10.12691/ajcmr-2-1-7

Abstract

Purpose: Our purpose was to identify the predictors of refractory epilepsy (RE) and the typical clinical findings in Bulgarian patients with RE. Patients and Methods: We studied 70 adult patients with refractory epilepsy and 70 patients with pharmaco sensitive epilepsy. The Liverpool Seizure Severity Scale was completed by 84.29% of the patients with RE. Results: The typical clinical findings and significant predictors of RE on univariate analysis were: high initial seizure frequency (OR = 2.45), heredity for epilepsy (OR = 8.90), febrile seizures (OR = 4.50), partial epilepsy (OR = 5.98), low or lacking seizure reduction with the first AED (OR = 44.0), clusters of seizures and/or epileptic status in the disease course (OR = 16.5), childhood onset (OR = 8.0), great number of ineffective antiepileptic drugs (AED) – OR = 232.88, poly therapy (OR = 61.0). On multivariate analysis significant predictors of RE were poly therapy (B = 4.86), childhood onset (B = 2.79), and great number (> 4) of ineffective AED (B = 5.44). Frequent clinical findings were: moderate seizure severity, high seizure frequency despite the prescribed treatment, polymorphic seizures. Conclusion: The most significant predictors of RE are: great number of ineffective AED, treatment with poly therapy, and early disease onset. This conclusion may be useful for a timely identification of patients with epilepsy who are likely to be refractory to medical therapy.

Keywords:
predictor refractory epilepsy clinical finding typical

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