The Investigation of Refractory Epilepsy Etiology in Children Referred to Tabriz Children Hospital

Abstract

Epilepsy is the most common neurological disease in pediatrics. About a third of the patients with any type of seizure have refractory seizures. Refractory epilepsy leads to an increase in mortality, disturbance of life quality, and psychiatric problems. Materials and Methods: This is a descriptive-analytical cross-sectional study. 100 patients were chosen under the age of 18 years with refractory epilepsy that had been referred to VEEG and VEEM had confirmed their refractory epilepsy. Also selected patients had complete files of the disease. They entered the study after receiving their consent. Their VEEG results were reviewed by the professor of pediatric neurologist again. Additional information was removed from the patient's file including brain MRI, Brain CT scan, and metabolic screen. For classification of their seizures were used Results: In this study, 74 patients (74.0%) had seizures on a daily. The mean age (SD) of the onset of refractory seizures was 26.44 (±3.5) Months. The most common causes of VEEG indication in these individuals were identify candidates for epilepsy surgery and diagnose the epilepsy syndrome with 43 cases (0.43%) and 41 cases (41.0%), respectively. From 100 patients who underwent VEEM, the frequency of seizure type was 47 patients (47.0%) Focal, of which Focal onset> awareness unknown> motor> tonic was the most common with 18 cases (18.0%) and 47 patients (47.0%) Generalized, of which Generalized onset> motor> myoclonic was the most common with 19 cases (19.0%) and 6 patients (6.0%) were of the Combined type, respectively. The most common cause of refractory epilepsy in these subjects was unknown with 75 cases (75.0%). From 100 patients studied, according to VEEM, 38 patients (38.0%) were diagnosed as Epilepsy Syndrome, of which the highest frequency being related to Epileptic spasm and Lennox-Gastaut each with 5 cases (5.0%); From 62 other patients, the most common was Localized Related Epilepsy with 41 cases (41.0%). Also, the highest comorbidity was related to Global Developmental Delay and Intellectual disability with 40 cases (40.0%) and 29 cases (29.0%), respectively. In this study, there was no significant relationship between the variables of Epilepsy Syndrome and Epilepsy Type with the presence comorbidity in the subjects (P-value> 0.05); But on the other hand, a statistically significant relationship was observed between the etiology and the presence comorbidity (P-value = 0.025).