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Background The majority of epilepsy patients have good prognosis, but lOAO% will develop intractable epilepsy. Early identification of patients v.ith risks of developing intractable epilepsy allows more intensive therapy to be performed.
Objective To study clinical characteristics and electroencephalography (EEG) features of intractable childhood epilepsy.
Methods We reviewed children \\lith intractable epilepsy attending the Pediatric Neurology and Growth and Development Clinic in Child Health Department, Cipto Mangunkusumo Hospital from 20052008. EEG examination was perfonned in epilepsy patients who had consumed two or more antiepileptic drugs for at least 18 months but still experienced seizure at least once per month. Data of clinical characteristics were collected from the medical records and information provided by the parents.
Results There were 41 subjects. Age of onset between o 1 year old was found in 50% subjects, neurological impainnent in 80%, microcephaly in 50%, and abnonnal neuroimaging in 14 of 24 subjects. Seizure manifestations were mostly generalized tonic clonic, tonic, my oclonic, and complex partial seizures. Abnonnal
EEG features were found in 88% subjects and the majority showed generalized sloMng of the background activity. Focal and multifocal epileptifonn activity was found in 31 % and 28% subjects, respectively. Epileptifonn activity was located mostly in the frontal and temporal lobe.
Conclusions Most patients Mth intractable epilepsy haveage of onset before the age of 1 year. A substantialpoportionof them have neurological impairment, microcephaly,abnonnal neuroimaging, and abnormal EEG features. Seizure manifestation ismostlygeneralized seizure. Epileptiform activity in intractable childhood epilepsy is often found in the frontal and temporal lobe.
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