Document Detail

Patterns of treatment response in newly diagnosed epilepsy.
MedLine Citation:
PMID:  22573629     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To delineate the temporal patterns of outcome and to determine the probability of seizure freedom with successive antiepileptic drug regimens in newly diagnosed epilepsy.
METHODS: Patients in whom epilepsy was diagnosed and the first antiepileptic drug prescribed between July 1, 1982, and April 1, 2006, were followed up until March 31, 2008. Outcomes were categorized into 4 patterns: (A) early and sustained seizure freedom; (B) delayed but sustained seizure freedom; (C) fluctuation between periods of seizure freedom and relapse; and (D) seizure freedom never attained. Probability of seizure freedom with successive drug regimens was compared. Seizure freedom was defined as no seizures for ≥1 year.
RESULTS: A total of 1,098 patients were included (median age 32 years, range 9-93). At the last clinic visit, 749 (68%) patients were seizure-free, 678 (62%) on monotherapy. Outcome pattern A was observed in 408 (37%), pattern B in 246 (22%), pattern C in 172 (16%), and pattern D in 272 (25%) patients. There was a higher probability of seizure freedom in patients receiving 1 compared to 2 drug regimens, and 2 compared to 3 regimens (p < 0.001). The difference was greater among patients with symptomatic or cryptogenic than with idiopathic epilepsy. Less than 2% of patients became seizure-free on subsequent regimens but a few did so on their sixth or seventh regimen.
CONCLUSIONS: Most patients with newly diagnosed epilepsy had a constant course which could usually be predicted early. The chance of seizure freedom declined with successive drug regimens, most markedly from the first to the third and among patients with localization-related epilepsies.
M J Brodie; S J E Barry; G A Bamagous; J D Norrie; P Kwan
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Publication Detail:
Type:  Journal Article     Date:  2012-05-09
Journal Detail:
Title:  Neurology     Volume:  78     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-15     Completed Date:  2012-07-09     Revised Date:  2013-06-25    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1548-54     Citation Subset:  AIM; IM    
Western Infirmary, Glasgow.
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MeSH Terms
Aged, 80 and over
Anticonvulsants / therapeutic use*
Chi-Square Distribution
Epilepsy / diagnosis*,  drug therapy*
Longitudinal Studies
Middle Aged
Retrospective Studies
Time Factors
Treatment Outcome
Young Adult
Reg. No./Substance:
Comment In:
Neurology. 2012 May 15;78(20):1542-3   [PMID:  22573642 ]

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