New study highlights predictive factors for intractable epilepsy

warning sign

A possible new method of predicting which epilepsy patients have intractable variants of the condition has been developed by researchers in China.

Carried out by researchers at Shanghai Jiao Tong University and published in the medical journal Epilepsy & Behavior, the study looked at a number of early predictors of medical intractability in epilepsy that could be used to identify serious cases within six months of initial diagnosis.

Medical intractability can be defined as the failure of more than two antiepileptic drugs at maximum tolerated doses to offer substantial seizure relief. Patients with intractable epilepsy experience an average of more than one seizure per month, with no more than three consecutive months of seizure freedom.

For this new research, the team examined all children under the age of 12 assessed at Xinhua Hospital between 1992 and 2006 who had had two or more unprovoked seizures 24 hours apart.

In total, 649 patients were identified, out of whom 119 met the study definition of intractable epilepsy at two years after diagnosis. The analysis revealed that neurodevelopmental delay, symptomatic etiology, partial seizures and the occurrence of more than ten seizures before diagnosis could be considered significant and independent risk factors for intractable epilepsy.

It was revealed that the best model to predict medical intractability in epilepsy comprised neurological physical abnormality, age at onset of epilepsy under one year, more than ten seizures before diagnosis and partial epilepsy. This testing method was also shown to be most appropriate for patients with idiopathic syndromes.

The researchers concluded that this new predictive model is “comparatively accurate and simple to apply clinically”, making it a potentially useful tool in the future management of the condition.

Intractable epilepsy is also sometimes known as uncontrolled or refractory epilepsy and tends to be more difficult to treat. However, there are a number of therapy options available for affected patients, including surgery and vagal nerve stimulation.

Posted by Steve Long