Abstract Details

Title Epidemiology of Drug-resistant Epilepsy in Latin America and the Caribbean: Systematic Review Update and Meta-analysis

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P10 - Poster Session 10 (11:45 AM-12:45 PM)

Poster/Presentation
Number 1-008

Objective To determine the prevalence of drug-resistant, controlled and non-optimally controlled epilepsy in Latin America and the Caribbean.

Background Drug-resistant epilepsy (DRE) is a challenging condition that demands more specialized management compared to other forms of epilepsy. Despite a global prevalence of approximately 30%, Latin American and the Caribbean (LAC) socioeconomic and cultural factors could suggest a higher prevalence and incidence of this condition in the region.

Design/Methods A systematic search was performed in PubMed, Embase, SCOPUS, Cochrane Central, WOS, Lilacs and Scielo, for studies conducted up to September 11th, 2023. Studies aiming to assess the epidemiology (prevalence and incidence) of DRE, controlled epilepsy (CE) and non-optimally controlled epilepsy (NOCE) were selected. In addition, only observational studies written in English, Spanish and Portuguese were included. NOCE was defined as a composite outcome of drug resistant epilepsy, partially controlled, indeterminate, uncontrolled, and pseudo-refractory epilepsy. Quality assessment was performed using the Newcastle-Ottawa scale for observational studies. A single-arm, random effects model meta-analysis of proportions was conducted, using the I2 statistics to measure the statistical heterogeneity.

Results A total of 1653 studies were screened, resulting in 11 selected studies, representing a total of 2294 patients. The pooled proportion of drug resistant epilepsy was 41% CI 95 [25%,56%; I2=99%]. In addition, the pooled proportion of CE and NOCE was 46% CI 95 [26%, 67%; I2=98%] and 68% CI 95 [48%, 87%; I2=99%]. Quality assessment showed medium to high risk of bias.

Conclusions In LAC, the prevalence of DRE is higher than global estimates. In addition, the estimates for CE and NOCE are shown below and above, respectively, compared to global data. This could indicate that there are determinants different from those that produce DRE that generate worse control of seizures due to epilepsy in LAC. These determinants could be cultural, economic and health-related.

Authors/Disclosures
Niels V. Pacheco, MD PRESENTER	Mr. Pacheco has nothing to disclose.
Carlos Alva-Diaz	Carlos Alva-Diaz has nothing to disclose.
Andre Lapeyre Rivera	Mr. Lapeyre Rivera has nothing to disclose.
Luis F. Purisaca Neira, MD (UNIVERSIDAD NACIONAL PEDRO RUIZ GALLO)	Dr. Purisaca Neira has nothing to disclose.
Daniel Fernandez-Guzman (Unsaac)	No disclosure on file
Poul Espino-Alvarado	No disclosure on file
John Rolston	John Rolston has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neuropace. The institution of John Rolston has received research support from NIH. The institution of John Rolston has received research support from Raynor Foundation. The institution of John Rolston has received research support from Pediatric Epilepsy Research Foundation. The institution of John Rolston has received research support from Lennox-Gastaut Foundation.
Jorge G. Burneo, MD, MSPH, FAAN (University of Western Ontario)	Dr. Burneo has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier, Clinical Neurology and Neurosurgery Journal. Dr. Burneo has received research support from The Jack Cowin Endowed Chair in Epilepsy Research. Dr. Burneo has received publishing royalties from a publication relating to health care. Dr. Burneo has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Jazz Pharmaceuticals.

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