Predictors of pharmacoresistant epilepsy

Hitiris, N., Mohanraj, R., Norrie, J., Sills, G. J. and Brodie, M. J. (2007) Predictors of pharmacoresistant epilepsy. Epilepsy Research, 75(2-3), pp. 192-196. (doi:10.1016/j.eplepsyres.2007.06.003) (PMID:17628429)

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Abstract

Outcome data were analysed from 780 patients newly diagnosed with epilepsy and followed up at a single centre over a 20-year period to investigate which clinical factors predicted pharmacoresistance. Patients were divided at the time of analysis into those whose seizures had been controlled for at least the last 12 months of follow up (n = 462) and those whose epilepsy remained refractory (n = 318). Numbers of pre-treatment seizures were greater in uncontrolled patients. Those reporting more than 10 seizures prior to initiation of therapy were more than twice as likely to develop refractory epilepsy. Univariate and multivariate logistic regression analyses demonstrated that pharmacoresistance was also associated with family history of epilepsy, previous febrile seizures, traumatic brain injury as the cause of the epilepsy, intermittent recreational drug use, and prior or current psychiatric comorbidity, particularly depression. Factors not predicting poorer outcome included gender, neurological deficit and mental retardation. The most interesting new finding was the correlation between psychiatric comorbidity and lack of response to antiepileptic drug therapy. The deleterious neurobiological processes that underpin depression, anxiety and psychosis may interact with those producing seizures to increase the extent of brain dysfunction and thereby the likelihood of developing pharmacoresistant epilepsy.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Brodie, Professor Martin and Norrie, Prof John and Hitiris, Dr Nikolas and Sills, Dr Graeme
Authors: Hitiris, N., Mohanraj, R., Norrie, J., Sills, G. J., and Brodie, M. J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > School of Life Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Epilepsy Research
Publisher:Elsevier
ISSN:0920-1211
ISSN (Online):1872-6844

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