CHARACTERIZING DRUG-RESISTANCE IN ADULTS WITH NEW-ONSET EPILEPSY

Abstract

Background and objectives: There are very few studies reporting the factors involved in or the rate of drug-resistant epilepsy (DRE) in adults with new-onset epilepsy (NOE). This prospective cohort study characterizes DRE and risk factors in a pure adult cohort with NOE or newly diagnosed epilepsy (NDE). There are very few studies reporting the factors involved in or the rate of DRE in adults with NO and NDE. Methods: Patients were selected from a prospective cohort followed between 2011 and 2018 from the Single Seizure Clinic (SSC) in Saskatoon, SK. The SSC sees patients who experience their first seizure and approximately 30% are diagnosed with epilepsy. We identified the following variables and outcomes in the cohort: age, gender, epilepsy type, seizure onset, etiology, epilepsy syndromes, EEG and imaging outcomes, and the rates of DRE. Inclusion criteria included patients with NO and NDE, age 18 years or older at time of diagnosis, and a minimum 1 year of follow‐up. Results: Ninety-five patients were included, 46 females and 49 males. Median age of onset was 33 years. Of those, 20.0% developed DRE between 2011-2018. Average time between onset and DRE diagnosis was 2.32 years. Bivariate analysis identified age, gender, and etiology as important risk factors for DRE, however these variables failed to be significant in the multivariate model. Discussion: A lower percentage of DRE was identified in this cohort of adults compared to any other published study at present. The majority of patients to develop DRE were diagnosed in the first year of follow up, showing the importance of early characterization and treatment. Similarly, a younger age of onset was shown to be a substantial indicator of the prognosis. Despite a small cohort and insignificant statistical outcomes, our findings might guide the directions of future research in this topic. Significance: The specificity of the cohort along with the outcomes identified in this study contribute valuable information about NOE in adults and the development of DRE. This study has laid the groundwork for not only a larger cohort study to be implemented in the future, but also several other studies to evaluate potential predictors such as specific imaging results as a risk factor for DRE and quality of life assessment through follow-up related to DRE risk.