Abstracts

Rationale: There is no universally accepted definition of pseudo intractable epilepsy. Pseudo intractability means, that resistance to treatment is in fact caused by clinical errors. Its main causes are errors in diagnosis, errors in drug choice or management, or poor medication compliance (Komarek V, Hovorka J,In:Brázdil M, Hadač J, Marusič P a kol. Farmakorezistentní epilepsie. Praha:Triton, ISBN 80-7254-562-0, 2004:171-172).Methods: This was a retrospective study. The study group consists of 100 patients (54 of them are women) with epilepsy, who were advised to our epileptology and neuropsychiatry department witt initial diagnosis of intractable epilepsy. All of them were considered possible candidates for epilepsy surgery. None of this group of patients finally underwent the epilepsy surgery. All of these patients are now seizure free for minimum of two years. We have studied reasons of previous intractability, and impact on psychosocial functioning.Results: In 35 patients we observed a failure to correctly classify the seizure type and epileptic syndrome classification(patients with idiopathic generalized epilepsy were treated as a focal seizures with a wrong choice of drug). In 45 patients inadequate medication was observed (inadequate dose in 23 out of them). Eleven patients had poor compliance in a dosing schedule. In 9 patients, triggering factors such as alcohol and drugs abuse have been observed. Conclusions: Our results show the main causes of pseudo-intractability in treatment and management of epilepsy. It is essential to consider errors in diagnosis, inadequate medications and compliance in every case of intractable epilepsy to prevent pseudo-intractability with poor impact on psychosocial functioning. Our study suport hight incidence of pseudo-intractability in population of patients with epilepsy.