Prediction for relapse and prognosis of newly diagnosed epilepsy
Article first published online: 8 AUG 2012
© 2012 John Wiley & Sons A/S
Acta Neurologica Scandinavica
Volume 127, Issue 2, pages 141–147, February 2013
How to Cite
Prediction for relapse and prognosis of newly diagnosed epilepsy. Acta Neurol Scand: 2013: 127: 141–147. © 2012 John Wiley & Sons A/S., , , , , , .
- Issue published online: 22 JAN 2013
- Article first published online: 8 AUG 2012
- Manuscript Accepted: 3 JUL 2012
- Nanjing Medical Major Scientific and Technological Development Foundation. Grant Number: 2007-02-11
- Health Department Preventive Medicine Scientific Research Foundation. Grant Number: Y201034
- newly diagnosed epilepsy;
- prognosis of epilepsy;
- seizure relapse;
- risk factors
The objective of this study was to investigate the timing of therapy initiation and other clinical factors as potential predictors for relapse and prognosis of epilepsy, based on hospital-based prospective observational data in China.
One hundred and seventy-one newly diagnosed patients with one or more seizures were recruited and followed for at least 2 years. Kaplan–Meier survival analysis was used for calculating recurrence and remission rates. Univariate and multivariate analyses for risk factors were performed using Cox proportional hazards model.
Among the 171 patients analyzed, more patients had partial (54.4%) than generalized seizures (45.6%). The range of patients' age was 6–70 years, but 70% were under 16 years of age. Multiple seizure types (HR = 2.01; 95% CI, 1.31–3.10), epileptiform electroencephalogram (EEG) abnormality (HR = 1.95; 95% CI, 1.09–3.49), and >1 seizure monthly before treatment (HR = 2.74; 95% CI, 1.69–4.51) were predictors of seizure recurrence. The best negative predictors of remission were as follows: relapse (HR = 0.13; 95% CI, 0.07–0.23) and epileptiform EEG within 1 year of treatment (HR = 0.61; 95% CI, 0.39–0.97). Delayed treatment after three or more seizures did not significantly increase the risk of recurrence (P = 0.70) or remission (P = 0.31) compared with early treatment after one or two seizures.
Multiple seizure types, epileptiform EEG abnormality, and >1 seizure monthly before treatment predict seizure recurrence. Relapse and epileptiform EEG within 1 year of treatment predict adverse seizure outcome. Early treatment does not affect relapse or prognosis.