Risk factors for childhood refractory epilepsy in a tertiary care centre, Chennai, India

ABSTRACT

Background: Intractable epilepsy is the pragmatic problem during the treatment of active epilepsy in children. Several risk factors are associated with incidence of intractable/recurrent epilepsy. The current study was done to identify the risk and prognostic factors associated with recurrent epilepsy (RE).Methods: This descriptive study was conducted on 152 children with idiopathic or symptomatic epilepsy who are on two or more AEDs and who were in follow up in Neurology OPD and inpatients in medical ward at ICH&HC, Chennai. All patients underwent relevant investigations to identify the possible risk factors for incidence of RE in study population. Karyotyping was done for idiopathic cases.Results: Male preponderance was seen in the study (MF-21). Risk factors such as male sex, age onset of seizures, type of seizures, developmental delay, CNS congenital anomalies, h/o perinatal injury, neuroabnormality, abnormal MRI and EEG was found to have statistically significant association with incidence of RE. No significant association was observed for the factors microcephaly, behavioural abnormalities, h/o febrile seizures and h/o status epilepticus with incidence of RE. No chromosomal abnormalities were detected in idiopathic cases.Conclusions: Early identification, risk factor analysis and understanding in the dynamics of the disease helps the physician in initiating the appropriate treatment, thereby avoiding the wrong therapy, low dose therapy and infrequent therapy. Above all identification of the risk factors helps in parental counseling and prepare them for expected outcome.