Associated Factors in Response to Treatment in Children with Refractory Epilepsy

Considering 10-20% of children with epilepsy continue to have seizure despite the appropriate treatment; this study was done to determine the associated factors in response to treatment in children with refractory epilepsy attending in Mofid children's hospital, Tehran, Iran.

This cross-sectional study was done during one year on 150 children with refractory epilepsy in Mofid children's hospital, Tehran, Iran. Demographic and clinical information, history, type of seizure, the number and type of drugs and treatment response were recorded by interview with parents and refer to medical recorded form. Patients who had no seizure in last year defined as a seizure free and patients who had more than 50% reduction in time or number of seizure defined as a relative response and relationship between different variables and treatment response was determined.

The mean age of patients was 83.5±51.14 month and 65 (43.3%) were female and 85 (56.7%) were male. Forty-nine (32.7%) had idiopathic epilepsy and 91 (57.6%) had symptomatic epilepsy. No response and relative response was seen in 74 (49.3%) and 20 (13.3%) respectively and 56 (37.3%) was seizure free. Response to treatment had significant difference between idiopathic epilepsy and symptomatic epilepsy (p=0.049). There was not significant difference between response to treatment with sex, family relation of parents, history of neonatal asphyxia and icter, preterm labor and microcephaly, gestational age, muscle tonicity, early age of onset and family history of seizure.

Results show that symptomatic seizure had significant effect on response to treatment and these patients had worst response to antiepileptic drugs.