Predictors of drug-resistance in epilepsy with auditory features
Introduction
Epilepsy with auditory features (EAF) accounts for approximately 1% of all people with epilepsy, characterized by seizures with auditory or aphasic symptoms, negative neuroimaging findings in most patients, and high probability to generalize (Bisulli et al., 2018; Florindo et al., 2006; Pippucci et al., 2015). A recent study suggested that seizure free is difficult to sustain long-term in EAF (Bisulli et al., 2018). Only 34% of the EAF patients achieved five seizure-free years (Bisulli et al., 2018). It remains difficult to avoid drug-resistance in EAF. Investigating predicting factors of drug-resistance may provide more effective treatment regimens in EAF.
However, few studies have focused on drug-resistant epilepsy (DRE) predictors in EAF. Only one study with >100 patients investigated the predictors of seizure freedom (Bisulli et al., 2018). In addition, it remains unclear whether antiepileptic drugs (AEDs) are the predictors of drug-resistance in EAF. More studies are needed to systematically address DRE predictors of EAF. In this study, we investigated the risk factors that may be early predictors of drug-resistance and expected that these risk factors might provide an intervention point to minimize the risk of drug-resistance in EAF.
Section snippets
Study design and participants
This study has a retrospective cohort design, approved by the Ethics Committee of the West China Hospital of Sichuan University. We reviewed medical records of all consecutive patients with auditory symptoms and/or receptive aphasia, referred to the Epilepsy Center of West China Hospital between 2009 and 2019. Inclusion criteria: patients with (1) confirmed diagnosis of epilepsy according to International League Against Epilepsy (Fisher et al., 2014), (2) at least 2 epileptic seizures with
Subject identification and comparison of the clinical features
The selection process is shown in Fig. 1. A total of 107 patients with EAF were included, and 48.6% of them were diagnosed as DRE. Among them, 48.6% were male, and the average age was 29.2 years, with a range of 13.0–78.8 years. The minimum duration of follow-up was 1.6 years. It was likely inherited as an autosomal-dominant trait for 8 patients with family history. No causative variant was identified. Four patients underwent surgery.
The characteristics of the included patients and univariate
Discussion
In the present study, the focus was on the predictors of drug-resistance in EAF. The main findings were as follows: (1) approximately half of EAF patients were diagnosed as DRE; (2) age at seizure onset < or = 10 and seizures during sleep were positive predictive factors of drug-resistance; (3) oxcarbazepine as the first AED is a protect predictor of drug-resistance in EAF.
Another similar study evaluated the prognostic factors in a large cohort of EAF patients, which suggested that age at onset
Conclusion
Our study suggests that three predictors, age at seizure onset <10 years, the first AEDs, and seizures during sleep may aid in early diagnosis of drug-resistance in EAF. The most meaningful predictor associated with drug-resistance in this cohort appears to be the first AEDs. Our study supports that early use of oxcarbazepine is a negative predictor of drug-resistance, which provides an intervention point to minimize the risk of drug-resistance in EAF. However, due to the small sample and
Declaration of Competing Interest
The authors declare no financial or other conflicts of interest.
Acknowledgements
This work was supported by National Nature Science Foundation of China (No. 81871018).
References (15)
- et al.
The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for treatment of partial epilepsy: an unblinded randomised controlled trial
Lancet
(2007) - et al.
Early predictors of outcome in newly diagnosed epilepsy
Seizure
(2013) - et al.
Factors predicting uncontrolled seizures in epilepsy with auditory features
Seizure
(2019) - et al.
Recurrent secondary generalization in frontal lobe epilepsy: predictors and a potential link to surgical outcome?
Epilepsia
(2015) - et al.
Epilepsy with auditory features: long-term outcome and predictors of terminal remission
Epilepsia
(2018) - et al.
Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs: a 30-year longitudinal cohort study
JAMA Neurol.
(2018) - et al.
Novel LGI1 mutation in a family with autosomal dominant partial epilepsy with auditory features
Neurology
(2003)
Cited by (2)
Optimization design for slip/no-slip configuration of hydrophobic sliding bearings using Monte Carlo search
2023, Tribology InternationalCitation Excerpt :The hydrophobic surface may bring about the boundary slippage at the fluid solid interface. Some reported studies [5–11] show that partial boundary slippage of hydrophobic surface could significantly improve the tribological performance of sliding bearings, such as friction loss (Floss) and load carrying capacity (LCC). Extensive theoretical and experimental researches have been carried out to validate the effect of boundary slippage on the improving the tribological performance in hydrodynamic lubrication regime.
The CB<inf>2</inf> receptor as a novel therapeutic target for epilepsy treatment
2021, International Journal of Molecular Sciences