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Clinico-Etiologic Profile of Children and Adolescents with Drug-Resistant Epilepsy in a low-Resource Setting: 10

Dipti Kapoor1, Divyani Garg2, Nitya Beriwal1

  • 1Department of Pediatrics (Neurology Division), Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India.

Journal of Child Neurology
|May 19, 2023
PubMed

Insights

Perinatal adverse events and brain infections are the leading causes of drug-resistant epilepsy in children. Preventive measures, including improved perinatal and neonatal care, can reduce this burden.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Public Health

Background:

  • Drug-resistant epilepsy affects 25-30% of children with epilepsy.
  • Etiology of epilepsy varies geographically, with limited data from low-resource settings.
  • Understanding regional causes is crucial for targeted interventions.

Purpose of the Study:

  • To describe the clinical and etiologic profile of pediatric drug-resistant epilepsy.
  • To identify region-specific concerns in a low-resource setting.
  • To inform preventive strategies for drug-resistant epilepsy.

Main Methods:

  • Retrospective chart review over 10 years (2011-2020).
  • Inclusion of children aged 1 month to 18 years meeting International League Against Epilepsy (ILAE) criteria for drug-resistant epilepsy.
  • Analysis of clinical data, perinatal history, EEG, MRI, and other evaluations.

Main Results:

  • 593 children enrolled; 52.3% males.
  • Most common seizure type: generalized (76.6%), particularly epileptic spasms (48.1%).
  • Predominant etiologies: perinatal adverse events (e.g., asphyxia 37.9%) and infections; West syndrome (48%) and Lennox-Gastaut syndrome (6.2%) were common electroclinical syndromes.

Conclusions:

  • Perinatal brain injury and infections are primary causes of pediatric drug-resistant epilepsy in this region.
  • Improved perinatal care, institutional deliveries, and optimized neonatal care are vital.
  • Vaccination against meningitis and Japanese B encephalitis can reduce the burden.

Keywords:
West syndromeantiseizure drugshypoxic-ischemic encephalopathyseizures

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