Characteristics and predictive biomarkers of drug resistant epilepsy -- study in Georgia

Abstract

Aim:The authors conducted a case-control study to estimate predictive factors for timely identification of patients at higher risk for developing drug resistant epilepsy. Methods: The retrospective case-control study was conducted among people diagnosed as having drug resistant epilepsy (cases) and their controls, identified as having drug-responsive seizures. All participants were admitted to the tertiary Epilepsy Center at the Institute of Neurology and Neuropsychology (Tbilisi, Georgia) during 2011. The data on demographic features and disease characteristics were analyzed. Multiple logistic regression analysis was used to identify independent risk factors for development of intractable epilepsy. Results: A total 334 patients were identified; 84 (34%) met the criteria for drug resistant epilepsy. One hundred and sixty-four age-and gender-matched controls with drug-responsive epilepsy were identified. Relative to the control group, the drug resistant seizure group had increased frequency of perinatal pathology (24% vs. 12%), febrile seizures (22% vs. 12%), seizure frequency at disease manifestation (62% vs. 19%), occurrence of convulsive seizures (84% vs. 70%), electroencephalo-graph (EEG) epileptiform discharges (94% vs. 77%), polytherapy (90% vs. 12%), multilobar lesions (30% vs. 16%), hippocampal sclerosis (18% vs. 5%), and malformations of cortical development (8% vs. 2%). Multivariate analysis indicated four factors with independent predictive value for development of intractable epilepsy: frequency of seizure, polymorphism of seizure, polytherapy, and epileptiform EEG abnormalities. Original ArticleThis is an open access article distributed under the terms of the Creative Commons AttributionNonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. 192The presence of all four factors in combination resulted in a 98% of probability of developing drug resistant epilepsy. Conclusion: Several factors appear to have prognostic value in identifying the risk for drug resistant epilepsy. These factors may prove useful in non-specialized health care settings for timely identification of individuals with elevated risk for drug resistant epilepsy. However, retrospective design and possible recall bias must be considered when interpreting or extrapolating these results.

Proteomic profiling of the rat hippocampus from the kindling and pilocarpine models of epilepsy: potential targets in calcium regulatory network

“…Changes in the expression of immediate-early genes, receptors which recognize excitatory and inhibitory neurotransmitters and ion channels have been recognized in epileptic patients and animal models of epilepsy 11 , 22 . Available drug therapies can only target symptoms rather than causes in epileptic patients 23 . Herein proteomic profiling of the rat hippocampus from the kindling and pilocarpine models of epilepsy was performed to unravel epileptogenic insults-induced changes in protein regulatory networks.…”

Role of Biomarkers in Epileptogenesis: A Concise Review

“…Biomarkers connected to an encouraging variable could be valuable for seizure expectation and the conceivable advancement of failed intercessions. For most patients, be that as it may, the character of encouraging variables is obscure [16]. The assortment of potential instruments and the diverse calculated parts of epileptogenesis and ictogenesis recommend various conceivable biomarker targets [17].…”