Refractory epilepsy in a Chinese population

• Published in: Clinical neurology and neurosurgery Vol. 109; no. 8; pp. 672 - 675
• Main Authors: Hui, Andrew C.F, Wong, Adrian, Wong, H.C, Man, B.L, Au-Yeung, K.M, Wong, K.S
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.10.2007; Elsevier Science; Elsevier Limited
• Subjects: Adolescent; Adult; Age Factors; Aged; Anticonvulsants - therapeutic use; Asian Continental Ancestry Group - statistics & numerical data; Biological and medical sciences; Children & youth; Classification; Drug Resistance - ethnology; Epilepsy; Epilepsy - drug therapy; Epilepsy - ethnology; Epilepsy - etiology; Female; Hong Kong; Humans; Intellectual disabilities; Intellectual Disability - complications; Magnetic resonance imaging; Male; Medical sciences; Mesial temporal sclerosis; Middle Aged; Multivariate analysis; Neurology; Neurosurgery; Primary care; Prospective Studies; Refractory epilepsy; Regression analysis; Risk Factors; Sclerosis - complications; Seizures; Sex Factors; Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Temporal Lobe - pathology; Hong Kong; Hong Kong China; China; Refractory epilepsy; Mesial temporal sclerosis; Magnetic resonance imaging; Seizures; Nervous system diseases; Surgery; Epilepsy; Central nervous system disease; Chinese; Nuclear magnetic resonance imaging; Cerebral disorder
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2007.05.016

Abstract Objectives To investigate the proportion of Chinese patients with intractable seizures and the risk factors leading to refractory epilepsy. Methods Consecutive patients over 14 years of age attending a Neurology clinic were evaluated. Patients with epilepsy were classified into two groups according to their seizure control: refractory or seizure-free. Epilepsy was classified as idiopathic as defined by age-related onset and typical electroclinical characteristics, symptomatic if secondary to a structural abnormality and cryptogenic if the cause was unknown. Age, sex, epilepsy syndrome classification, aetiology, presence of mental retardation and the number of drugs used were compared between patients with refractory epilepsy and those in remission. Results Among 260 adolescent and adult patients with a mean age of 34 years (range 15–79), complete seizure control was achieved in 157 (60%) cases. Multivariate binomial logistic regression analysis showed that patients with mesial temporal sclerosis (OR = 7.6, 95% CI 3.53–16.4, p < 0.01) and the presence of mental retardation (OR = 9.39, 95% CI 3.98–22.12, p < 0.01) were more likely to develop pharmacoresistant epilepsy. Conclusion In adults the underlying aetiology is an important factor as to whether patients develop intractable seizures. Poor control was also associated with the presence of mesial temporal sclerosis and mental retardation.