Predictors of intractable epilepsy in childhood

A case-control study

Anne T. Berg, Susan R. Levy, Edward J. Novotny, Shlomo Shinnar

Research output: Contribution to journalArticle

166 Citations (Scopus)

Abstract

Little is known about what factors predict intractable epilepsy at the time of initial diagnosis. We performed a case-control study to identify early predictors of medically intractable epilepsy in children. Cases were children who had an average of one seizure or more a month over a 2-year period and who, during that time, had failed trials of at least three different antiepileptic drugs (AEDs). Controls were children who had epilepsy, who had been seizure-free for ≥2 years, and who had never, before becoming seizure-free, met the definition for intractable epilepsy. Strong univariate associations were noted between intractability and several factors: infantile spasms (IS) remote symptomatic epilepsy, a history of status epilepticus (SE) before the diagnosis of epilepsy, neonatal seizures, and microcephaly. Cases were significantly younger than controls at onset (1.8 vs. 5.8 years); this was not due solely to cases with onset during the first year of life but was an association apparent throughout the age range studied. With multiple logistic regression, independent predictors of intractability were IS, odds ratio (OR) = 10.42, p = 0.03; age at onset with a decreasing risk with increasing age, OR = 0.77 per year, p < 0.0001; remote symptomatic epilepsy, OR = 2.24, p = 0.04; and SE, OR = 3.30, p = 0.04. These findings complement those of recent cohort studies of remission of epilepsy and provide useful leads for future prospective studies of intractable epilepsy.

Original languageEnglish (US)
Pages (from-to)24-30
Number of pages7
JournalEpilepsia
Volume37
Issue number1
DOIs
StatePublished - Jan 1996

Fingerprint

Case-Control Studies
Epilepsy
Seizures
Odds Ratio
Infantile Spasms
Status Epilepticus
Microcephaly
Age of Onset
Anticonvulsants
Cohort Studies
Logistic Models
Drug Resistant Epilepsy
Prospective Studies

Keywords

  • Age-at-onset
  • Epilepsy
  • Intractable epilepsy
  • Prognosis
  • Status epilepticus

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Predictors of intractable epilepsy in childhood : A case-control study. / Berg, Anne T.; Levy, Susan R.; Novotny, Edward J.; Shinnar, Shlomo.

In: Epilepsia, Vol. 37, No. 1, 01.1996, p. 24-30.

Research output: Contribution to journalArticle

Berg, Anne T. ; Levy, Susan R. ; Novotny, Edward J. ; Shinnar, Shlomo. / Predictors of intractable epilepsy in childhood : A case-control study. In: Epilepsia. 1996 ; Vol. 37, No. 1. pp. 24-30.
@article{7cd7a5a35a8b4e08bc5ee373d15beaa4,
title = "Predictors of intractable epilepsy in childhood: A case-control study",
abstract = "Little is known about what factors predict intractable epilepsy at the time of initial diagnosis. We performed a case-control study to identify early predictors of medically intractable epilepsy in children. Cases were children who had an average of one seizure or more a month over a 2-year period and who, during that time, had failed trials of at least three different antiepileptic drugs (AEDs). Controls were children who had epilepsy, who had been seizure-free for ≥2 years, and who had never, before becoming seizure-free, met the definition for intractable epilepsy. Strong univariate associations were noted between intractability and several factors: infantile spasms (IS) remote symptomatic epilepsy, a history of status epilepticus (SE) before the diagnosis of epilepsy, neonatal seizures, and microcephaly. Cases were significantly younger than controls at onset (1.8 vs. 5.8 years); this was not due solely to cases with onset during the first year of life but was an association apparent throughout the age range studied. With multiple logistic regression, independent predictors of intractability were IS, odds ratio (OR) = 10.42, p = 0.03; age at onset with a decreasing risk with increasing age, OR = 0.77 per year, p < 0.0001; remote symptomatic epilepsy, OR = 2.24, p = 0.04; and SE, OR = 3.30, p = 0.04. These findings complement those of recent cohort studies of remission of epilepsy and provide useful leads for future prospective studies of intractable epilepsy.",
keywords = "Age-at-onset, Epilepsy, Intractable epilepsy, Prognosis, Status epilepticus",
author = "Berg, {Anne T.} and Levy, {Susan R.} and Novotny, {Edward J.} and Shlomo Shinnar",
year = "1996",
month = "1",
doi = "10.1111/j.1528-1157.1996.tb00507.x",
language = "English (US)",
volume = "37",
pages = "24--30",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Predictors of intractable epilepsy in childhood

T2 - A case-control study

AU - Berg, Anne T.

AU - Levy, Susan R.

AU - Novotny, Edward J.

AU - Shinnar, Shlomo

PY - 1996/1

Y1 - 1996/1

N2 - Little is known about what factors predict intractable epilepsy at the time of initial diagnosis. We performed a case-control study to identify early predictors of medically intractable epilepsy in children. Cases were children who had an average of one seizure or more a month over a 2-year period and who, during that time, had failed trials of at least three different antiepileptic drugs (AEDs). Controls were children who had epilepsy, who had been seizure-free for ≥2 years, and who had never, before becoming seizure-free, met the definition for intractable epilepsy. Strong univariate associations were noted between intractability and several factors: infantile spasms (IS) remote symptomatic epilepsy, a history of status epilepticus (SE) before the diagnosis of epilepsy, neonatal seizures, and microcephaly. Cases were significantly younger than controls at onset (1.8 vs. 5.8 years); this was not due solely to cases with onset during the first year of life but was an association apparent throughout the age range studied. With multiple logistic regression, independent predictors of intractability were IS, odds ratio (OR) = 10.42, p = 0.03; age at onset with a decreasing risk with increasing age, OR = 0.77 per year, p < 0.0001; remote symptomatic epilepsy, OR = 2.24, p = 0.04; and SE, OR = 3.30, p = 0.04. These findings complement those of recent cohort studies of remission of epilepsy and provide useful leads for future prospective studies of intractable epilepsy.

AB - Little is known about what factors predict intractable epilepsy at the time of initial diagnosis. We performed a case-control study to identify early predictors of medically intractable epilepsy in children. Cases were children who had an average of one seizure or more a month over a 2-year period and who, during that time, had failed trials of at least three different antiepileptic drugs (AEDs). Controls were children who had epilepsy, who had been seizure-free for ≥2 years, and who had never, before becoming seizure-free, met the definition for intractable epilepsy. Strong univariate associations were noted between intractability and several factors: infantile spasms (IS) remote symptomatic epilepsy, a history of status epilepticus (SE) before the diagnosis of epilepsy, neonatal seizures, and microcephaly. Cases were significantly younger than controls at onset (1.8 vs. 5.8 years); this was not due solely to cases with onset during the first year of life but was an association apparent throughout the age range studied. With multiple logistic regression, independent predictors of intractability were IS, odds ratio (OR) = 10.42, p = 0.03; age at onset with a decreasing risk with increasing age, OR = 0.77 per year, p < 0.0001; remote symptomatic epilepsy, OR = 2.24, p = 0.04; and SE, OR = 3.30, p = 0.04. These findings complement those of recent cohort studies of remission of epilepsy and provide useful leads for future prospective studies of intractable epilepsy.

KW - Age-at-onset

KW - Epilepsy

KW - Intractable epilepsy

KW - Prognosis

KW - Status epilepticus

UR - http://www.scopus.com/inward/record.url?scp=0030058842&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030058842&partnerID=8YFLogxK

U2 - 10.1111/j.1528-1157.1996.tb00507.x

DO - 10.1111/j.1528-1157.1996.tb00507.x

M3 - Article

VL - 37

SP - 24

EP - 30

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 1

ER -