Objective:

This study re-evaluates the prevalence of DRE, its correlation with comorbid neurological and psychiatric conditions, and identifies factors predictive of seizure control.

Background:

About one-third of persons with epilepsy develop drug-resistant epilepsy (DRE). 

Design/Methods:

This cross-sectional study conducted in a level 3 epilepsy center. DRE, defined as failure to achieve seizure control after adequate trials of two antiseizure medications, was compared with seizure-free patients (seizure-free >6 months). 

Results:

Of 613 patients, 188 (30.6%) had DRE, while 425 (69.3%) were seizure-free. The mean ages were 40 years in the DRE group and 43 years in the seizure-free group. The mean age at seizure onset was 22.3 years in the DRE group and 24.5 years in the seizure-free group. Mean disease duration was similar, at 17.7 years for DRE patients and 18.5 years for seizure-free patients. Focal epilepsy was more common in the DRE group (61.2%) compared to the seizure-free group (24%) (p < 0.0001). Generalized epilepsy was more prevalent in the seizure-free group (40%) than in the DRE group (30.9%) (p = 0.16). ADHD was reported in 12% of DRE patients and 9.1% of seizure-free patients (p = 0.25). Major depression was less prevalent in the DRE group (10.1%) compared to the seizure-free group (25.8%) (p < 0.0001). Generalized anxiety disorder (GAD) was found in 20% of DRE patients and 24% of seizure-free patients (p = 0.30). Developmental disability and learning disability (DD/LD) were more prevalent in DRE patients (29.2% and 29.7%) compared to the seizure-free group (15.2% each) (p < 0.0001). Autism was found in 8.5% of DRE patients and 5.8% of seizure-free patients (p = 0.20).

Conclusions:

DD/LD is significantly more common in DRE patients, with higher rates of ADHD, GAD, and autism. These findings suggest the need for targeted interventions to improve outcomes for these patients.