| Assessing the risk of subsequent tonic-clonic seizures in patients with a history of simple or complex partial seizures. | |
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MedLine Citation:
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PMID: 22696580 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BackgroundPatients who present with only simple or complex partial seizures have a poorly documented prognosis. Treatment may be advocated to prevent future secondary generalised seizures, reduce the frequency of further simple or complex partial seizures or a combination of both.MethodsA full statistical analysis on 1334 patients was carried out. The outcomes measured were post-randomisation times to first seizure of any type and first tonic-clonic seizure. Methodology was adopted that accounted for individuals' underlying pre-randomisation seizure counts and allowed for the possibility that there may be a proportion of the sample that will not experience post-randomisation seizure recurrence.Results103 subjects randomised to the MESS (Multicentre Study of Early Epilepsy and Single Seizures) study had only partial seizures at randomisation. Only 17 of these had a tonic-clonic seizure during follow-up. The presence of an abnormal EEG at randomisation influenced this risk: an estimated 23% of those with EEG abnormality were at risk of tonic-clonic seizures during follow-up compared with 16% of those with a normal EEG. The group did, however, continue to have partial seizures during follow-up, and modelling showed that the impact of treatment on these seizures was significantly less than the effects of treatment on the frequency of tonic-clonic seizures in those patients with such pre-randomisation seizures.ConclusionPatients presenting with a history of only partial seizures are at low risk of subsequent tonic-clonic seizures in the period of time to which therapeutic decisions are relevant. The effects of the antiepileptic drugs used in the MESS study are greater for tonic-clonic seizures than they are for partial seizures. |
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Authors:
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Jennifer K Rogers; Jane Hutton; Anthony G Marson; David W Chadwick |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-6-13 |
Journal Detail:
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Title: Journal of neurology, neurosurgery, and psychiatry Volume: - ISSN: 1468-330X ISO Abbreviation: - Publication Date: 2012 Jun |
Date Detail:
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Created Date: 2012-6-14 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 2985191R Medline TA: J Neurol Neurosurg Psychiatry Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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