Risk factors for intractable epilepsy at the time of initial diagnosis were determined in a case-control study at Yale University, New Haven, CT. Children with an average of one seizure or more per month over a 2-year period and refractory to at least 3 different AEDs were compared to controls who had been seizure-free for >2 years and had never had intractable epilepsy. Independent predictors of intractability were infantile spasms, early age of onset, remote symptomatic epilepsy, and status epilepticus. [1]

COMMENT. Age at onset was the predominant predictor of seizure intractability in this study, even after controlling for infantile spasms as a cause. Prognosis was progressively better with increasing age at onset during childhood and adolescence. For reports of neuropathology associated with intractable epilepsy, see Progress in Pediatric Neurology I, 1991, pp 131-138; and II, 1994, pp 129-141.