Risk Factors of Intractable Epilepsy in Young Children Aged Less than 3-Year old

Abstract

Background: Epilepsy is one of the most common serious neurological disorders. Early onset epilepsy associated with significant co-morbidity that affecting a child’s behavior, mood, social skills and ability to learn.
Objective: To determine the risk factors of intractable epilepsy in childhood epilepsy among aged less than 3 years old.
Method: This was a retrospective analytical case control study. Patient charts of all 1 - 36 months who had new-onset epilepsy from Bhumibol Adulyadej Hospital, Thailand between 1 January 2008 to 30 June 2019 were reviewed. Children were divided into two groups: Intractable and non intractable epilepsy.
Results: Total epilepsy 233 case. One hundred forty-five case was eliminate from the study (19 febrile convulsions, 126 not epilepsy). Eighty eight cases were included for statistical analysis. Intractable and non-intractable epileptic patients composed of 22 and 66 members, respectively. The cohort consisted of 51.14% (45/88) male, and 48.86% (43/88) female patients. Intractable epilepsy were found development delay at aged diagnostic 100% (22/22), perinatal complication 72% (16/22), preterm labor 18% (4/22), prior febrile seizure 36% (8/22), prior status epilepticus 54% (12/22), generalize epilepsy 63% (14/22), abnormal CT/MRI brain 81% (18/22), abnormal EEG 40% (4/22), first degree family epilepsy 4% (1/22).The 5 statistic significant predictors of intractable epilepsy included developmental delay at diagnosis, perinatal complication, prior status epilepticus, generalized epilepsy, abnormal CT/MRI brain. Multivariable logistic regression indicated that only generalized epilepsy was a predictor of intractable epilepsy.
Conclusion: Twenty five percent epileptic patients of age less than 3 years were medically intractable. A comprehensive risk factors of intractable epilepsy, namely developmental delay at diagnosis, perinatal complication of birth asphyxia, prior status epilepticus, generalize epilepsy, and structural brain abnormality seen as abnormal CT/MRI bran scan.