Abstracts

Rationale: Epilepsy is usually characterized as being responsive to medications or drug-resistant. However, the severity of the disease varies between patients and may change significantly with time. Our aim was to define a scale of severity and patterns of disease change with time and to find correlations between these patterns and patients' characteristics. Methods: We identified patients with a clear diagnosis of epilepsy, without non-epileptic events and who did not undergo epilepsy surgery from the epilepsy clinic database (containing retrospective data up to 9/2010 and prospective data after this date) and extracted information on demographics and disease characteristics. Based on a 1-10 scale of severity, we defined 6 patterns of progression: responding after 2 drug regimens , responding after more than 2 drug regimens, improving, stable, relapsing-remitting (RR), and progressive. Results: From 170 included patients, 26% were responders, 6% improving, 12% stable, 48% RR, and 8% progressive. When the seizures occurring after reduction of medications were excluded (revealing the pathophysiological pattern), the group of responders changed to 40% and RR - to 32%. Age of disease onset, imaging findings and type of epilepsy influenced belonging to pathophysiologic responders. More women than men belonged to the RR pattern. Conclusions: Characterization of epilepsy patients using our scale and patterns of progression reflects their clinical condition in more detail than the drug-responsive vs. resistant labeling. Therefore, it may better support clinical decision making. In addition, this clinical classification may aid in characterization of different pathophysiological groups of epilepsy and ictogenesis, thus guiding the use of more specific treatments in the future.