بررسي يافته هاي پاراكلينيك و نتايج درماني در كودكان مبتلا به صرع مقاوم مراجعه كننده به بيمارستان مفيد در سال 87-1386

Paraclittical findings and treatment response of children with refractory epilepsy in Mofid Childrenʹs Hospital in 2007-2008

Background and purpose: There are many challenges in diagnosis and treatment of patients with refractory epilepsy. The aim of this study was to survey the paraclinical findings in children with refractory epilepsy in Mofid Childrenʹs Hospital and their effect on treatment response.Materials and methods: This cross-sectional study was undertaken in 2007 to 2008. One hundred and fifty patients with refractory epilepsy in Mofid Childrenʹs Hospital were studied. Demographic, Clinical and paraclinical information of all patients were collected using a questionnaire and the date analyzed with SPSS and chi-square test. Results: The mean age of patients was 83.5±51.1 months, 43.3% were female. Idiopathic epilepsy and symptomatic epilepsy were detected in 32.7% and 57.6% of the subjects respectively. There were abnormal biochemical findings (hypoglycemia, hypocalcaemia or abnormal liver function) in 3.3% of the subjects and abnormal metabolic findings in 8%. EEG findings were normal in 2.7%, non-specific in 42.7% and abnormal in 54.6% of the children. Abnormal brain CT-scan and MRI findings were observed in 39.3% and 42.7% respectively. No response and relative response were obtained in 49.3% and 13.3% of the subjects respectively and 37.3% were seizure free. Treatment response in patients with abnormal EEG, brain CT-scan and MRI were significantly poorer than that of the patients with normal EEG (normal or non-specific), CT-scan and MRI findings. Conclusion: It seems that brain abnormality (abnormal findings in imaging) and cortical dysfunction in EEG were the factors that resulted in treatment response in patients with refractory epilepsy.