Clinical Prediction Rule of Drug Resistant Epilepsy in Children

BACKGROUND AND PURPOSE: Clinical prediction rules (CPR) are clinical decision-making tools containing variables such as history, physical examination, diagnostic tests by developing scoring model from potential risk factors. This study is to establish clinical prediction scoring of drug-resistant epilepsy (DRE) in children using clinical manifestationa and only basic electroencephalography (EEG). METHODS: Retrospective cohort study was conducted. A total of 308 children with diagnosed epilepsy were recruited. Primary outcome was the incidence of DRE. Independent determinants were patient characteristics, clinical manifestations and electroencephalography. CPR was performed based on multiple logistic regression. RESULTS: The incidence of DRE was 42%. Risk factors were age onset, prior neurological deficits, and abnormal EEG. CPR can be established and stratified the prediction using scores into 3 levels such as low risk (score<6), moderate risk (score 6–12) and high risk (score>12) with positive likelihood ratio of 0.5, 1.8 and 12.5 respectively. CONCLUSIONS: CPR with scoring risks were stratified into 3 levels. The strongest risk is prior global neurological deficits.