The Natural History of Epilepsy in the Era of New Antiepileptic Drugs and Surgical Treatment


Address correspondence and reprint requests to Dr. J. W. Sander at Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, U.K.


Summary:  Purpose: To review the factors influencing prognosis of epilepsy in this era of antiepileptic drugs and surgical treatment.

Methods: Systematic review of peer-reviewed literature.

Results: The prognosis depends on many factors; aetiology, age of onset, number of siezures at onset, the natural history of the condition, and the influence of treatment. However, between 70 and 80% of people developing epilepsy will go into long-term remission, usually within the first 5 years.

Discussion: Prognosis in epilepsy is the prospect of attaining complete seizure freedom once a pattern of recurrent epileptic seizures has been established. Well-designed prospective cohort studies using standard outcome measures need to be conducted, especially in non-Western cultures.