Fattori predittivi di farmacoresistenza nell’epilessia in età evolutiva.

Drug-resistance (DR) was defined as at least one seizure every 3 months of the last year of follow-up evaluation or until successful seizure surgery and failure of three or more AEDs at maximum tolerated doses. We report 118 patients, with a mean age at the first and the last observations respectively of 3 yrs 9 mths and 8 yrs 10 mths. Patients were divided into two groups: one with a drug-resistant epilepsy and the other one without a drug-resistant epilepsy. We assessed the sample in different moments of the follow-up: T0 (onset of epilepsy), T2 (2 yrs after the onset), T5 (5 yrs) and T10 (10 yrs). Several variables were evaluated to find a correlation with a possible DR. Predictors of DR were: age at onset < 6 years (p < 0.01 at T2), a symptomatic / probable symptomatic aetiology (p < 0.01 at T2, T5 and T10), the presence of partial seizures (p < 0.05 at T10) and the failure of the first drug (p < 0.00000001 at T2, p < 0.05 at T5). Furthermore, the long latency between the onset of seizures and the first drug was related to a worse prognosis in T2 (p < 0.05). However, we did not found a significant correlation between DR and family history of epilepsy, gender, presence of febrile seizures, neurological examination, intelligent quotient, EEG features at the onset and the type of drug. PB, VPA and CBZ were the drugs more utilized. Our data show that 36.5% of drug-resistant patients had a diagnostic change during follow- up and that 5.6% of the subjects became drug-resistant after discontinuation of an efficacious therapy. There are still many questions about DR concerning definition, pathogenesis, reversibility and so on. Our work is in progress in order to define which other variables are related to DR.