Boonluksiri et al reported a clinical decision rule for identifying a pediatric patient with drug-resistant epilepsy. This can help to identify a patient who may require more aggressive management. The authors are from Hatyai Hospital, Mahidol University and Chiangmai University in Thailand.
Patient selection: pediatric patient < 15 years old with epilepsy
Parameters:
(1) age at onset in years
(2) prior neurologic deficits
(3) EEG
Parameter
Finding
Points
age at onset
< 5 years
2.5
5 to 12 years
0
13 to 14 years
1.5
prior neurological deficit
normal
0
motor
9
mental
6
global
13
EEG
normal
0
epileptic discharges
3.5
non-epileptic discharges
1
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 19
• The higher the score the greater the risk for drug-resistant epilepsy.
Total Score
Risk Group
Positive Likelihood Ratio
< 6
mild
0.54
6 to 12
moderate
1.8
> 12
high
12.5
Performance:
• The area under the ROC curve is 0.76.
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