Abstract
The International League Against Epilepsy (ILAE) has recently defined drug resistance (DR) as a failure of adequate trials of two tolerated and appropriately chosen and used AED schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom. We studied the prognostic factors of DR in 117 patients affected by epilepsy with onset during childhood or adolescence, with a mean age at the first and the last observation respectively of 3 yrs 3 mths and 9 yrs 10 mths. Patients were divided into two groups: one with DR and the other one without DR. In DR cases some parameters prevailed, in particular presence of symptomatic etiology, lesions on MRI, EEG abnormalities at the onset and positive neurological examination, seizure frequency and seizure clustering, poor or delayed response to first AED. PB, VPA, and CBZ were the most utilized drugs. We reviewed the most relevant 10 variables by multiple logistic regression. The most reliable combinations of DR predictors are: partial or no response to the first AED, the presence of seizure clustering during the course of epilepsy, slightly or very altered neurological examination and long latency between onset of epilepsy and first AED administered at T2; partial or no response to the first AED and positive MRI at T5; positive MRI and absence of generalized seizures at T8; and positive MRI at T10. Our data show that 14.4% of the subjects at T5, 16.6% at T8 and 24.3% at T10 became drug-resistant after discontinuation of an efficacious therapy.
| Original language | Italian |
|---|---|
| Pages (from-to) | 117-124 |
| Number of pages | 8 |
| Journal | Bollettino - Lega Italiana contro l'Epilessia |
| Issue number | 145 |
| Publication status | Published - Apr 2013 |
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ASJC Scopus subject areas
- Clinical Neurology
Cite this
Fattori prognostici di farmacoresistenza nell'epilessia dell'infanzia e dell'adolescenza. / Russo, A.; Posar, A.; Conti, S.; Parmeggiani, A.
In: Bollettino - Lega Italiana contro l'Epilessia, No. 145, 04.2013, p. 117-124.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Fattori prognostici di farmacoresistenza nell'epilessia dell'infanzia e dell'adolescenza
AU - Russo, A.
AU - Posar, A.
AU - Conti, S.
AU - Parmeggiani, A.
PY - 2013/4
Y1 - 2013/4
N2 - The International League Against Epilepsy (ILAE) has recently defined drug resistance (DR) as a failure of adequate trials of two tolerated and appropriately chosen and used AED schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom. We studied the prognostic factors of DR in 117 patients affected by epilepsy with onset during childhood or adolescence, with a mean age at the first and the last observation respectively of 3 yrs 3 mths and 9 yrs 10 mths. Patients were divided into two groups: one with DR and the other one without DR. In DR cases some parameters prevailed, in particular presence of symptomatic etiology, lesions on MRI, EEG abnormalities at the onset and positive neurological examination, seizure frequency and seizure clustering, poor or delayed response to first AED. PB, VPA, and CBZ were the most utilized drugs. We reviewed the most relevant 10 variables by multiple logistic regression. The most reliable combinations of DR predictors are: partial or no response to the first AED, the presence of seizure clustering during the course of epilepsy, slightly or very altered neurological examination and long latency between onset of epilepsy and first AED administered at T2; partial or no response to the first AED and positive MRI at T5; positive MRI and absence of generalized seizures at T8; and positive MRI at T10. Our data show that 14.4% of the subjects at T5, 16.6% at T8 and 24.3% at T10 became drug-resistant after discontinuation of an efficacious therapy.
AB - The International League Against Epilepsy (ILAE) has recently defined drug resistance (DR) as a failure of adequate trials of two tolerated and appropriately chosen and used AED schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom. We studied the prognostic factors of DR in 117 patients affected by epilepsy with onset during childhood or adolescence, with a mean age at the first and the last observation respectively of 3 yrs 3 mths and 9 yrs 10 mths. Patients were divided into two groups: one with DR and the other one without DR. In DR cases some parameters prevailed, in particular presence of symptomatic etiology, lesions on MRI, EEG abnormalities at the onset and positive neurological examination, seizure frequency and seizure clustering, poor or delayed response to first AED. PB, VPA, and CBZ were the most utilized drugs. We reviewed the most relevant 10 variables by multiple logistic regression. The most reliable combinations of DR predictors are: partial or no response to the first AED, the presence of seizure clustering during the course of epilepsy, slightly or very altered neurological examination and long latency between onset of epilepsy and first AED administered at T2; partial or no response to the first AED and positive MRI at T5; positive MRI and absence of generalized seizures at T8; and positive MRI at T10. Our data show that 14.4% of the subjects at T5, 16.6% at T8 and 24.3% at T10 became drug-resistant after discontinuation of an efficacious therapy.
KW - Adolescence
KW - Childhood
KW - Diagnosis
KW - Drug-resistance
KW - Epilepsy
KW - Long term follow-up
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=84887267543&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84887267543&partnerID=8YFLogxK
M3 - Articolo
AN - SCOPUS:84887267543
SP - 117
EP - 124
JO - Bollettino - Lega Italiana contro l'Epilessia
JF - Bollettino - Lega Italiana contro l'Epilessia
SN - 0394-560X
IS - 145
ER -