Caracterización de pacientes con epilepsia refractaria, atendidos en el servicio de consulta externa de neurología pediátrica del Hospital de Niños Dr. Roberto Gilbert Elizalde, durante el periodo enero 2015 a diciembre 2021.

Abstract

Background: Epilepsy is a common neurological pathology in the pediatric population. Its treatment is generally carried out with antiepileptic drugs. However, there are cases of resistance to pharmacological treatment. Objectives: The objective of this study was to characterize the pediatric patients with refractory epilepsy who have been treated in the outpatient clinic at Dr. Roberto Gilbert Elizalde Children’s Hospital for the January 2015- December 2021. Methodology: Study retrospective, transversal, descriptive, observational. Out of 1099 patients diagnosed with of epilepsy, 131 patients with refractory epilepsy were determined. From them, 106 patients made up the study population of this study according to the established inclusion and exclusion criteria. Results: A predominance was found in the male sex and debut between 1-12 months. Epileptic seizures of generalized onset were the most frequent. The notable personal history was hypoxic-ischemic encephalopathy and nervous system infections. Most of the electroencephalographic patterns identified were of generalized involvement. The notable neuroimaging alterations were those related to hypoxic-ischemic sequelae such as cortico-subcortical atrophy and encephalomalacia with gliosis. The most commonly used pharmacological treatment was polytherapy, especially dual therapy. The most used drugs were valproic acid, levetiracetam and oxcarbazepine. The most common combinations were valproic acid plus levetiracetam and levetiracetam plus lamotrigine. Other therapeutic approaches were surgery, ketogenic diet, vagus nerve stimulation, corticosteroids and immunoglobulins. Conclusions: The age of onset of epilepsy that progressed to refractory was less than 1 year. On the other hand, generalized electroencephalographic alterations are the most related to refractory epilepsy Lesions in the brain parenchyma, sequelae or malformations, are the main cause of drug-refractory epilepsy. The most used pharmacological treatment was dual therapy.