Which patients become seizure free with antiepileptic drugs? An observational study in 821 patients with epilepsy

• Published in: Acta neurologica Scandinavica Vol. 117; no. 1; pp. 55 - 59
• Main Authors: Bauer, J., Buchmüller, L., Reuber, M., Burr, W.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-01-2008; Blackwell
• Subjects: Adult; Anticonvulsants - pharmacology; Anticonvulsants - therapeutic use; Biological and medical sciences; Carbamazepine - pharmacology; Carbamazepine - therapeutic use; Cohort Studies; Drug Resistance - physiology; Drug Therapy, Combination; epilepsy; Epilepsy - drug therapy; Epilepsy - physiopathology; Epilepsy - prevention & control; Female; Fructose - analogs & derivatives; Fructose - pharmacology; Fructose - therapeutic use; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; monotherapy; Nervous system (semeiology, syndromes); Neurology; pharmacotherapy; Prognosis; Retrospective Studies; Secondary Prevention; seizure control; Treatment Outcome; Triazines - pharmacology; Triazines - therapeutic use; Valproic Acid - pharmacology; Valproic Acid - therapeutic use; Viral diseases; Viral diseases of the nervous system; Human; Drug; Nervous system diseases; Convulsion; Epilepsy; pharmacotherapy; Central nervous system disease; monotherapy; Anticonvulsant; Neurological disorder; seizure control; Cerebral disorder
• ISSN: 0001-6314; 1600-0404
• DOI: 10.1111/j.1600-0404.2007.00940.x

Objectives –  Analysis of factors influencing seizure outcome in antiepileptic drug treatment of epilepsy.
Patients and methods –  Retrospective analysis of 500 patients with complete seizure control and 321 patients with refractory epilepsy (mean ages 33.3 and 32.1 years respectively).
Results –  The seizure‐free group consisted of 377 patients with symptomatic/cryptogenic epilepsy (SCE; mean seizure control 45 months) and 123 patients with idiopathic generalized epilepsy (IGE; mean seizure control 61 months) (P = 0.02). Of the patients with SCE, 35.7% had achieved seizure control with monotherapy (MT), 29.6% with ≥2 AEDs. No single AED was superior in MT. Of the patients with IGE, 35.9% had become seizure free with MT, 15.6% on combination therapy (CT). Valproate MT was more commonly associated with seizure freedom than lamotrigine (P < 0.05).
Conclusions –  The results indicate that, in SCE, seizures can be controlled with carefully selected CT more commonly than suggested by previous studies. The seizure prognosis of patients with IGE presenting to a specialist in epilepsy may be worse than previously thought.