The Prevalence of Drug-Resistant-epilepsy and its Associated Factors in Patients with Epilepsy

Background: Drug-resistant-epilepsy (DRE) is a major challenge in adult patients with epilepsy. The majority of previous studies evaluating the risk factors of DRE have been conducted in children. Therefore, this study aimed to investigate the prevalence of DRE and its associated factors in adults. Methods: : All patients aged over 12 years with an established diagnosis of epilepsy since at least one year before the admission who were admitted with seizure to the neurology ward of a tertiary care hospital were consecutively included from 20th March 2014 to 19th March 2020. Patients were classified into two groups of DRE and non-DRE groups. The archived-files of the patients were retrospectively reviewed and the data were extracted and recorded in a pre-prepared checklist. Results: : A total of 436 patients were investigated. The most common causes of epilepsy were idiopathic (53.9%), vascular (22.5%), and CP/developmental disorders (8.3%). There was no significant difference between DRE and non-DRE patients in terms of age, sex, seizure type (generalized/partial). Vascular causes were more prevalent in the non-DRE group, and idiopathic, post-traumatic/surgery, MS/degenerative, poor compliance, CP/developmental disorders, and space-occupying lesions were more prevalent in the DRE group. In multivariate regression analysis only the presence of CP/developmental disorders was independently associated with a higher probability of DRE (adjusted OR= 2.170, 95% CI = 1.017 to 4.633, p = 0.045). Conclusion: The prevalence of DRE is still considerably high. Therefore, considering its serious consequences, more investigations should be carried out to determine proper strategies for reducing its incidence. We found the history of CP/developmental disorders to be independently associated with DRE. Therefore, perinatal care to reduce the incidence of CP/developmental disorders and encouraging these patients to use their medications accurately may be helpful.