Risk factors associated with drug resistant focal epilepsy in adults: A case control study

Roy, Pragma Laboni; Ronquillo, Lizbeth Hernández; Ladino, Lady Diana; Téllez‐Zenteno, José F.

doi:10.1016/j.seizure.2019.10.020

Cited by 35 publications

(25 citation statements)

References 29 publications

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“…At the same time, however, a previous study found that encephalomalacia may reduce the risk of drug-resistant focal epilepsy in adults. 5 Patient prognosis was not related to AEEG abnormalities, either in general or during specific parts of the sleep–wake cycle.…”

Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

“…4 Another recent study demonstrated that the predictors of poor outcome include partial seizure presentation, the presence of mesial temporal sclerosis or bitemporal epilepsy, and the use of a greater number of AEDs. 5 In this study, we examined data collected from a cohort of patients that was followed up for a median of 9.1 years. We investigated the possible clinical differences of patients that were seizure-free without the use of AEDs, patients that had pharmacoresponsive epilepsy, and patients that had pharmacoresistant epilepsy.…”

Section: Introductionmentioning

confidence: 99%

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A Scale for Predicting the Outcomes of Patients with Epilepsy: A Study of 141 Cases

Chen

Ma²,

Zhang³

et al. 2021

IJGM

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Objective This study aimed to identify the factors relevant for developing a scale to estimate the prognosis of patients with epilepsy. Methods This study followed 141 patients with newly or previously diagnosed epilepsy for between four and nine years. The patients were divided into three groups on the basis of their outcomes during the follow-up period: patients that were seizure-free without anti-epileptic drugs (AEDs) (group A, n = 48), patients with pharmacoresponsive epilepsy (group B, n = 52), and patients with pharmacoresistant epilepsy (group C, n = 41). The predictors of the prognosis of epilepsy were determined using logistic regression models and optimum subsets regression, and a scale for estimating the prognosis of epilepsy (SEPE) was developed. Results The SEPE was able to distinguish between better and worse outcomes for the three groups. A score ≤3 on the SEPE predicted that a patient would become seizure-free without the use of AEDs, with a specificity of 67% and a sensitivity of 50%. A score ≤4 on the SEPE predicted that a patient may have a positive outcome; scores in this range were assigned to 97.9% of patients that were seizure-free without the use of AEDs and 65% of patients with pharmacoresponsive epilepsy, with a specificity of 80%, a sensitivity of 81%. Scores ≥6 on the SEPE predicted a poor outcome. Conclusion Of the patients with a SEPE score ≤3, some were able to become seizure-free without the use of AEDs, while for other patients, it may be possible that AED use can be discontinued. Patients with a SEPE score ≤4 have the potential to achieve long-term remission. Patients with a SEPE score ≥6 are more likely to have pharmacoresistant epilepsy.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Scale for Predicting the Outcomes of Patients with Epilepsy: A Study of 141 Cases

Chen

Ma²,

Zhang³

et al. 2021

IJGM

View full text Add to dashboard Cite

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“…A diagnosis in the second decade of life, with more than one seizure with impaired awareness per month, mesial temporal sclerosis and bitemporal epilepsy are risk factors for DRE in focal epilepsy. 31 The drug resistance risk is higher in patients with cortical dysgenesis or hippocampal atrophy. 32 …”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Clinical Management of Drug Resistant Epilepsy: A Review on Current Strategies

Guéry

Rheims

2021

NDT

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Drug resistant epilepsy (DRE) is defined as the persistence of seizures despite at least two syndrome-adapted antiseizure drugs (ASD) used at efficacious daily dose. Despite the increasing number of available ASD, about a third of patients with epilepsy still suffer from drug resistance. Several factors are associated with the risk of evolution to DRE in patients with newly diagnosed epilepsy, including epilepsy onset in the infancy, intellectual disability, symptomatic epilepsy and abnormal neurological exam. Pharmacological management often consists in ASD polytherapy. However, because quality of life is driven by several factors in patients with DRE, including the tolerability of the treatment, ASD management should try to optimize efficacy while anticipating the risks of drug-related adverse events. All patients with DRE should be evaluated at least once in a tertiary epilepsy center, especially to discuss eligibility for non-pharmacological therapies. This is of paramount importance in patients with drug resistant focal epilepsy in whom epilepsy surgery can result in long-term seizure freedom. Vagus nerve stimulation, deep brain stimulation or cortical stimulation can also improve seizure control. Lastly, considering the effect of DRE on psychologic status and social integration, comprehensive care adaptations are always needed in order to improve patients' quality of life.

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“…In this disease the brain activities were abnormal and it affects the behavior, feelings, movements, and awareness of someone who is involved with this disease. 1 In a normal person electrical impulses were sent and received with nerve cells continuously and anything that disrupts these pathways can lead to a seizure. 2 Different agents like high fever, insufficient sleep, hyponatremia, head trauma, brain tumor, illegal drugs and alcohol abuse can lead to the epilepsy.…”

Section: Introductionmentioning

confidence: 99%

Development of Salt Induced Liquid–Liquid Extraction Combined with Amine Based Deep Eutectic Solvent-Dispersive Liquid–Liquid Microextraction; An Efficient Analytical Method for Determination of Three Anti-Seizures in Urine Samples

et al. 2020

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Background: A simple, fast, efficient, and environmentally friendly microextraction technique named salt induced liquid-liquid extraction combined with amine based deep eutectic solventdispersive liquid-liquid microextraction method followed by gas chromatography-flame ionization detector was applied for the determination of some anti-seizure drugs in urine samples. Methods: In this method, sodium chloride (30% w/v) was dissolved in the sample solution (adjusted at pH=10) as phase separation agent and iso-propanol was added to the solution. After manually shaking, the solution was centrifuged and the supernatant phase was removed and mixed with choline chloride: benzyl ethylenediamine (85 µL) and the mixture was rapidly dispersed into a deionized water containing 5.0 % w/v, sodium chloride and adjusted at pH=10. The cloudy solution was centrifuged and the sedimented phase was removed and 1 µL of it was injected into the determination system. Results: Under final conditions, the limits of detection and quantification at the ranges of 3.4-6.9, and 11.5-23.3 ng mL -1 were obtained, respectively. The relative standard deviations for intraand inter day assays were lower than 10.9%. The effect of exogenous and endogenous effect on the performance of the method was studied and the results showed that these factors were nearly effect less on the efficiency. Conclusion:The introduced method was satisfactorily utilized to determinate the selected benzodiazepines drugs in the patients' urine samples.

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Risk factors associated with drug resistant focal epilepsy in adults: A case control study

Cited by 35 publications

References 29 publications

A Scale for Predicting the Outcomes of Patients with Epilepsy: A Study of 141 Cases

A Scale for Predicting the Outcomes of Patients with Epilepsy: A Study of 141 Cases

Clinical Management of Drug Resistant Epilepsy: A Review on Current Strategies

Development of Salt Induced Liquid–Liquid Extraction Combined with Amine Based Deep Eutectic Solvent-Dispersive Liquid–Liquid Microextraction; An Efficient Analytical Method for Determination of Three Anti-Seizures in Urine Samples

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