Intractable Epilepsy - Treatment and Outcomes
Abstract number :
2.144
Submission category :
4. Clinical Epilepsy / 4C. Clinical Treatments
Year :
2022
Submission ID :
2204197
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:23 AM
Authors :
Naeem Mahfooz, MD – University of Toledo COM; Fahham Asghar, MD – Research Assistant, Neurology, University of Toledo COM LS; Elysia James, MD – Assistant Professor, Neurology, University of Toledo COM LS; Hira Pervez, MD – PGY-2 Resident, Neurology, University of Toledo COM LS; Sidra Saleem, MD – PGY 3 Resident, Neurology, University of Toledo COM LS; Rabia Zubair, MD – Assistant Professor, Neurology, University of Toledo COM LS; Bashar Saour, MD – Assistant Professor, Neurology, University of Toledo COM; Alaina Zhang, Medical Student – Medical Student, Neurology, University of Toledo COM LS; Imran Ali, MD – Professor, Neurology, University of Toledo COM LS; Ajaz Sheikh, MD – Associate Professor, Neurology, University of Toledo COM LS
Rationale: The purpose of our study was to estimate the prevalence of drug resistant epilepsy (DRE) in a busy urban epilepsy program; the frequency, type and variants of treatment options utilized to achieve seizure control in patients with intractable epilepsy.
Methods: This was a cross-sectional study with data gathered from persons with epilepsy (PWE) presenting to a tertiary care epilepsy center at their initial visit. Patients were grouped based on seizure control into intractable epilepsy and seizure free for more than 6 months. Drug resistance was defined as failure to achieve seizure control after adequate trials of two or more medications.
Results: Data were collected from 2270 patients presenting with a diagnosis of epilepsy. The cohort of this study was 524 patients out of which 169 (32.3%) were resistant to anti-seizure medication (ASM) treatment and were classified as intractable. In comparison, 355 (67.7%) patients were included who were free of seizures for a period of more than 6 months. The study patients were 46% men and 54% women; mean age of patients was 45.14±20 years. Patients with intractable epilepsy had an earlier seizure onset when compared to the well-controlled group. Variations in the treatment efforts of intractable epilepsy vs seizure-free more than 6 months group showed: ASM Polytherapy 82.8% vs 22.8%, resective epilepsy surgery 8.8% vs 4.2%, neurostimulation 23% vs 0.8%. A majority (67.8%) in the seizure free group were on monotherapy (Table 1). The most common resective surgical procedure for both groups was temporal lobectomy followed by lesionectomy. The most commonly utilized neurostimulation modality in both groups was vagus nerve stimulation (VNS).
Conclusions: Approximately 33% of PWE in our cohort had intractable epilepsy. Patients with intractable epilepsy had an earlier onset of seizures, were more likely to be on polytherapy and more likely to have failed resective surgery and or neurostimulation.
Funding: None
Clinical Epilepsy