RESISTANCE AU TRAITEMENT ET SYNDROME EPILEPTIQUE: ETUDE RETROSPECTIVE DE 500 DOSSIERS CLASSES SELON LA CLASSIFICATION INTERNATIONALE DE 1989

500 cases of confirmed epilepsy seen consecutively at the Centre Saint Paul for the first time in 1987-1988 were classified according the 1989 International Classification adopted at New Delhi, 87% of cases were classifiable, a proportion considered to be high with respect to the short duration of follow-up at our center (maximum 2 years). 49.6% of patients were controlled, 6.2% were not treated, 5% were on inadequate therapy, 2% were pseudoresistant due to non-epileptic seizures or irregular drug intake. 186 patients (37.6%) were considered truly drug-resistant with at least 1 seizure per year. The proportion was highest among cryptogenic or symptomatic generalized epilepsies (70.6% and 82.5% respectively), lowest among idiopathic partial or generalized epilepsies (0% and 20.9% respectively). Symptomatic partial epilepsies constitute a large group (186/500, i.e. 37% of the total population sample) with a sizeable proportion of resistant cases (79, i.e. 42.7%); among the latter group, further definition of drug resistance should lead to the selection of patients who need to be evaluated for epilepsy surgery.