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Refractory Childhood Epilepsy and Factors Related to Refractoriness
Author(s) -
Ohtsuka Yoko,
Yoshinaga Harumi,
Kobayashi Katsuhiro
Publication year - 2000
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.2000.tb02212.x
Subject(s) - refractory period , refractory (planetary science) , epilepsy , status epilepticus , tuberous sclerosis , pediatrics , medicine , electroencephalography , temporal lobe , anesthesia , psychiatry , biology , astrobiology
Summary: To clarify the characteristics of refractory childhood epilepsy, we compared recent refractory cases and those of approximately 15 years ago, all of which were seen at the Okayama University Hospital. We also analyzed predictive factors related to refractoriness in the recent refractory cases. Among the recent refractory cases, the proportion of localization‐related epilepsies increased, and the proportion of generalized epilepsies decreased compared to historical cases. In generalized epilepsies, the proportion of cases with Lennox‐Gastaut syndrome decreased to less than half. In localization‐related epilepsies, the proportion of cases with frontal lobe epilepsy increased. The proportion of cases with unknown causes decreased to less than half. Of the cases with known causes, postencephalitis/postencephalopathy and focal cortical malformation, including tuberous sclerosis, accounted for most of the cases. More of the recent refractory cases were treated with high‐dose AED monotherapy, compared to more poly‐therapy in the cases of 15 years earlier. The following factors were related to future refractoriness: less than 1 year of age at onset of seizures, the presence of underlying pathology, status epilepticus, changes in type of epilepsy during the clinical course, and neonatal seizures. Regarding EEG findings of cases that had localization‐related epilepsies at the end of follow‐up, focal spike‐waves associated with diffuse spike‐waves on the first EEGs indicated future refractoriness.