Predictors of Childhood Intractable Epilepsy- A Retrospective Study in A Tertiary Care Hospital

Abstract

Objective: To study the predictors of intractable childhood epilepsy and to compare
the predictors of outcome in early and late onset childhood epilepsy.
Design: Retrospective study.
Study place: Child Development and Neurology Unit in the Department of Paediatrics
of Bangabandhu Sheikh Mujib Medical University (BSMMU).
Study period: January 2004 to December 2005.
Subjects: Children with epilepsy of 1 month to 15 years of age who attended the
epilepsy clinic.
Results: The predictors of outcome of childhood epilepsy were analyzed. According
to outcome there were two groups, well- controlled group (seizure free for more than 6
months) and intractable epilepsy ( one or more seizures per month over a period of 6
months). The predictors of early and late onset childhood epilepsy were also compared.
Total 73 cases were studied. Out of them 38 patients had early onset epilepsy (less
than one year) and 35 had late onset epilepsy (more than one year). Median age of
onset of early and late onset of childhood epilepsy group was 3.5 months and 60
months respectively. Male and female ratio was 1.53:1 and 0.94:1 in early and late
onset group respectively. Major seizure type was tonic-clonic seizure in 57.9% and
77.1% patients of early and late onset group respectively. In this study, 27 (77.1%)
patients of late onset and 5(13.2%) patients of early onset group achieved seizure
remission. Independent predictors of intractable childhood epilepsy were finally found.
Conclusion: In this study symptomatic epilepsy, myoclonic seizure, initial high
frequency of seizure, infantile spasm, neonatal seizures and birth asphyxia were
significantly higher among early onset group than in late onset group. Early onset of
seizure, myoclonic seizure, initial high frequency of seizure (≥1 seizure/day),
symptomatic etiology, neonatal seizure and microcephaly were found independent
predictors of intractable epilepsy.

Key words: Early onset; late onset; intractable seizures.

DOI: 10.3329/bjch.v33i1.5669

Bangladesh Journal of Child Health 2009; Vol.33(1): 6-15