Abstracts

Rationale: Drug resistant epilepsy (DRE) is associated with poor prognostic outcomes such as reduced quality of life, higher rates of premature deaths, injuries and psychological illness. The International League Against Epilepsy (ILAE) defined DRE as “failure of adequate trials of two tolerated and appropriately chosen and used Anti-epileptic drug (AED) schedules to achieve sustained seizure freedom” Seizure freedom is defined as at least 3 times the duration of the longest interseizure interval prior to starting a new intervention or at least 12 months of seizure freedom. The objective of this study is to identify risk factors associated with DRE in Veteran patients seen with focal epilepsy in the setting of the Seizure Clinic at West LA VA Medical Center (WLAVAMC). Identification of risk factors would allow patients to receive individualized treatment plans and improve prognosis. Methods: Retrospective chart review of veterans with epilepsy between ages 18 and 75 seen in Seizure Clinic at WLAVAMC and previously diagnosed with focal epilepsy. Patients who met the criteria of DRE according to the ILAE classification were identified. The control group was formed with patients who did not meet the definition of DRE. In addition to demographic data the following variables were being collected: etiology, age of onset, seizure types, seizure frequency, triggers, response to AEDs, reported side-effects of AEDs, history of status epilepticus, seizure clusters, presence of developmental delay, history of febrile seizures and/or childhood epilepsy and family history. Results: Three-hundred patients with focal onset epilepsy have been identified. Of these patients 100 patients have fulfilled the definition of DRE. 97% are male. 55% have a history of traumatic brain injury (TBI) and more than 2 seizures/month. All patients in the DRE group have 2 or more seizure types and had tried and failed an average of 5.22 AEDs. None of the patients reported a history of status epilepticus, febrile seizures, childhood epilepsy or developmental delay. Patients with DRE were on an average of 3.22 AEDs. Conclusions: DRE is associated with poor prognostic outcomes. Our study suggests that risk factors for DRE in veterans with focal onset epilepsy are more than one seizure type, more than 2 seizures per month and history of TBI. Funding: None