Document Detail

How long does it take for partial epilepsy to become intractable?
MedLine Citation:
PMID:  12552028     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Much remains unknown about the natural history of intractable localization-related epilepsy, including how long it typically takes before intractability becomes evident. This information could guide the design of future studies, resolve certain discrepancies in the literature, and provide more accurate information about long-term prognosis.
METHODS: Individuals evaluated for resective surgery for refractory localization-related epilepsy were prospectively identified at the time of initial surgical evaluation at seven surgical centers (between 1996 and 2001). The latency time between onset of epilepsy and failure of second medication and history of remission (>/=1 year seizure-free) before surgical evaluation were examined with respect to age at onset, hippocampal atrophy, febrile seizures, and surgical site.
RESULTS: In the 333 patients included in the analysis, latency time was 9.1 years (range 0 to 48) and 26% reported a prior remission before surgery. A prior remission of >/=5 years was reported by 8.5% of study participants. Younger age at onset was strongly associated with longer latency time (p < 0.0001) and higher probability of past remission (p < 0.0001). In multivariable analyses, age at onset remained as the most important explanatory variable of both latency time and prior remission.
CONCLUSIONS: A substantial proportion of localization-related epilepsy may not become clearly intractable for many years after onset. This is especially true of epilepsy of childhood and early adolescent onset. If prospective studies confirm these findings and the underlying mechanisms behind these associations become understood, this raises the possibility of considering interventions that might interrupt such a process and some day prevent some forms of epilepsy from becoming intractable.
A T Berg; J Langfitt; S Shinnar; B G Vickrey; M R Sperling; T Walczak; C Bazil; S V Pacia; S S Spencer
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Neurology     Volume:  60     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-01-28     Completed Date:  2003-02-05     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  186-90     Citation Subset:  AIM; IM    
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MeSH Terms
Age of Onset
Anticonvulsants / therapeutic use
Disease Progression
Drug Resistance
Epilepsies, Partial / drug therapy,  physiopathology*,  surgery
Hippocampus / pathology
Interviews as Topic
Middle Aged
Prospective Studies
Remission Induction
Seizures, Febrile
Temporal Lobe / physiopathology,  surgery
Time Factors
United States
Grant Support
Reg. No./Substance:
Comment In:
Neurology. 2003 Jan 28;60(2):162-3   [PMID:  12552025 ]
Neurology. 2003 Jul 22;61(2):277; author reply 277   [PMID:  12874427 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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