Early predictors of intractability in childhood epilepsy: a community-based case-control study in Copparo, Italy

Objectives - To identify early predictors of intractability in childhood an d adolescence epilepsy. Materials and methods - We carried out a community- based case-control study using the incidence cohort of epileptic patients l iving in the district of Copparo, in the province of Ferrara, Italy. The co mparative study was performed in 31 cases and 95 controls. Cases were patie nts who averaged at least I unprovoked seizure per month during an observat ional, period of at least 2 years. Controls were subjects having achieved r emission for at least 5 years regardless of current therapy. Results - Onse t at age <1 year, remote symptomatic etiology and high frequency of seizure s before therapy were found to be independent early predictors of intractab ility. Conclusion - Our study suggested that the risk of developing intract able epilepsy may, to some extent, be predicted at the time of initial diag nosis in children with early-onset epilepsy of remote symptomatic etiology, especially if seizure propensity is initially high.