Abstracts

Rationale: To try to characterize adult patients with idiopathic generalized epilepsies (IGEs) to see if there are any common pattern or predicted factors related to refractoriness. Methods: Hospital records, including EEGs and imaging studies of 11 patients with refractory IGEs and 11 patients with non-refractory IGEs were reviewed.Results: Seizure control was not significantly associated with age, age of onset, age at diagnosis, delayed initial treatment, and exposure to inappropriate antiepileptic drugs (AEDs). There were certain associated conditions which were seen in the refractory group but not in the control group including suboptimally treated OSA (3/11, 27.3%), alcohol use (3/11, 27.3%), and medication non-compliance (4/11, 36.4%). On EEG, two of the patients in the refractory group have generalized paroxysmal fast activity (GPFA) and one has focal slowing, but none in the control group. Conclusions: Most patients with IGEs can be treated successfully with monotherapy. In this study, no particular clinical pictures stand out to explain the refractoriness to AEDs. In the group of refractory IGEs, the associated conditions such as suboptimally treated OSA, alcohol use, and non-compliance need to be looked at carefully before they are called truly refractoriness. GPFA and focal slowing may predict refractoriness, but given our small sample size, this is not conclusive. Presumably genetic difference between these two groups causes the true refractoriness. This result raises the question of whether it worthwhile to do DNA sequencing to compare these two groups. We plan to continue our study by recruiting more patients and including DNA sequencing to answer this question.