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Seizure. 2009 Jul;18(6):412-6. doi: 10.1016/j.seizure.2009.02.006. Epub 2009 Mar 26.

Early prediction of refractory epilepsy in childhood.

Author information

  • 1Department of Paediatrics, Paediatric Neurology Unit, Torrecárdenas Hospital, Almería, Spain. jramoslizana@telefonica.net

Abstract

PURPOSE:

To investigate early predictors (6 months after diagnosis) of refractory epilepsy.

METHODS:

STUDY DESIGN:

prospective cohort study.

INCLUSION CRITERIA:

all consecutive children <14 years with two or more unprovoked seizures 24h apart, who were seen at our hospital between 1994 and 2004.

EXCLUSION CRITERIA:

patients previously examined in other centres.

DEFINITIONS:

refractory epilepsy: failure of >2 drugs plus >1 seizure/month for >or=18 months.

ANALYSIS:

risk of developing refractory epilepsy was calculated using Kaplan-Meier survival curves. Univariable and multivariable analyses of potential predictors of developing refractory epilepsy were carried out using Cox proportional hazards model.

RESULTS:

343 patients were included. Mean age at diagnosis was 4.8 years (+/-3.8 SD). Mean follow-up period was 76.2 (+/-35.2 SD) months (range 24-139). Risk of developing refractory epilepsy was 8% at 6 years. Risk for idiopathic syndromes was 2%. For non-idiopathic syndromes the risk was 38% for patients with age at onset <1 year plus >1 seizure during the first 6 months after diagnosis, 9% for age at onset <1 year plus 0-1 seizures during the first 6 months, 22% for age at onset >or=1 year plus >1 seizures during the first 6 months and 3% for age at onset >or=1 year plus 0-1 seizures during the first 6 months.

CONCLUSION:

Risk of developing refractory epilepsy is very low in idiopathic syndromes. For the rest of patients, a simple model comprising three variables allows more accurate prediction of risk of refractoriness.

PMID:
19328019
[PubMed - indexed for MEDLINE]
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