Prediction for relapse and prognosis of newly diagnosed epilepsy

Authors


Qing Di, Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, 264 Guangzhou Road, Nanjing, Jiangsu 210029, China

Tel.: 0086 2582296373

Fax: 0086 2583712308

e-mail: diqing@medmail.com.cn

Abstract

Objective

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.

Methods

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.

Results

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.

Conclusions

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.

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