الفهرس 
Response to antiepileptics in epileptic patients with structural lesion in brain imaging
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Abstract
Background: Focal epilepsy is the most common form of epilepsy in adults and is frequently associated with an epileptogenic lesion. Advances in brain imaging allowed better identification of different structural lesions underlying focal epilepsy. However, the response to antiepileptics in lesional epilepsy is a heterogeneous condition Objectives: This study aimed to evaluate the response to antiepileptics in patients with lesional epilepsy and to identify the predictors for poor seizure control. Subjects and methods : This cross sectional study included 165 patients with the diagnosis of lesional epilepsy and fulfilling our inclusion criteria. Patients were subjected to full clinical assessment, MRI brain imaging epilepsy protocol and conventional EEG monitoring. Epilepsy was defined as {u2018}{u2018}well controlled{u2019}{u2019} if the patient reported less than one seizure per month. Resluts: 75.8 % of patients with lesional epilepsy showed poor response to antiepileptic medications. Younger age of the patient and younger age at seizure onset were significantly associated with poor seizure control. Patients with focal to bilateral tonic clonic convulsions were significantly poorly controlled than those with other seizure types (p=0.047) Regarding different MRI lesions, Cerebromalatic lesions related to brain trauma was the most frequently encountered (21.8%). Malformations of cortical development were significantly associated with poor seizure control (p=0.040) Polytherapy was associated with a poor response to medications (p=0.001), and higher percent of subjects were controlled on first generation AED (p=0.001). Logistic regression analysis revealed that younger age at seizure onset was associated with 0.965 times increase in risk of poor seizure control. Also, patients with abnormal EEG findings are 2.5 times more liable to poor seizure control