@article{article_1773677, title={Predictive factors for drug resistance in adult lesional epilepsy: Evidence from a cross-sectional study}, journal={Ege Tıp Dergisi}, volume={64}, pages={701–708}, year={2025}, DOI={10.19161/etd.1773677}, url={https://izlik.org/JA73JX88UN}, author={Aykaç, Şeyma and Dere, Birgül and Arı, Abdullah and Tunçel, Rasim and Eraslan, Cenk and Aydoğdu, İbrahim}, keywords={lesional epilepsy, drug resistant epilepsy, epilepsy related cerebral lesions, malformations of cortical development, seizure prognosis}, abstract={Aim: Lesional epilepsy accounts for a substantial proportion of epilepsy cases, with treatment outcomes varying according to lesion type. Identifying predictors of drug resistance is essential to guide management and surgical planning. This study evaluated clinical, radiological, and electroencephalographic (EEG) predictors of treatment response in adults with lesional epilepsy. Materials and Methods: Medical records of patients ≥18 years with MRI (magnetic resonance imaging)-confirmed structural lesions and ≥1 year of antiepileptic drug (AED) therapy were retrospectively reviewed. Patients with psychogenic non-epileptic seizures, acute symptomatic seizures, non-adherence, or prior epilepsy surgery were excluded. Data included demographics, seizure type, AED regimen, MRI lesion features, and interictal EEG findings. Drug resistance was defined as failure of two appropriately chosen, well-tolerated AED regimens. Results: Ninety-six patients (41 males, 45 females; mean age 42 years) were included. Encephalomalacia was the most frequent lesion (43%), followed by tumors (26%), malformations of cortical development (MCD) (8%), cystic lesions (6%), vascular malformations (6%), and mesial temporal sclerosis (5%). Drug resistance occurred in 26% of cases, with MCD showing the highest rate (62%, p = 0.026). Gender, age at onset, generalized motor seizures, EEG abnormalities, and lesion laterality were not significantly associated with drug resistance. Conclusion: MCD is strongly associated with AED resistance in adults with lesional epilepsy, while other lesion types tend to respond more favorably. Early recognition of high-risk patients may facilitate timely surgical evaluation and improve seizure control outcomes.}, number={4}