Long-term outcome of medically treated epilepsy

Abstract

While we still do not have a cure for epilepsy for all patients, relief of the medical and social consequences is available for many and hope is on the horizon for people with epilepsy.

Outcome of seizures in the general population after 25 years: a prospective follow-up, observational cohort study

“…This may be influenced by the long follow-up in this study, with the proportion seizure-free each year consistently greater than 80% after 6 years. This finding of higher proportions in terminal remission associated with longer follow-up was previously suggested in two smaller cohort studies 2 18. The high proportion with terminal remission seen in the NGPSE is not entirely explained by the inclusion of people with single seizures at presentation (table 3); 73% of those with more than one seizure at presentation were in terminal remission by the end of follow-up (80% in those with complete follow-up).…”

Prognostic factors of drug‐resistant epilepsy in childhood: An Italian study

“…In the literature, the definition and complex physiopathogenesis of DR, the latter resulting from the interaction of several factors, are widely discussed . According to Hauser, in theory all epilepsies should be considered as resistant to therapy because the action of AED is only palliative, and does not influence the causal pathobiology of the epilepsy .…”

“…In the literature, the definition and complex physiopathogenesis of DR, the latter resulting from the interaction of several factors, are widely discussed. [10][11][12][13][14][15][16][17][18][19][20][21] According to Hauser, in theory all epilepsies should be considered as resistant to therapy because the action of AED is only palliative, and does not influence the causal pathobiology of the epilepsy. 23 Cascino suggested a more operational definition at the clinical level by proposing as a DR marker the persistence of seizures over the years, even with appropriate mono/polytherapy and at the maximum tolerated doses.…”

“…The remaining 40% of drug‐resistant epilepsy can be considered idiopathic or without identifiable etiology (probable symptomatic) . In the literature, lack of response to the first drug, presence of symptomatic – or so presumed – epilepsy, high frequency of seizures at onset, seizure clusters, abnormalities observed on neurological examination and on electroencephalogram (EEG) are predictive factors of DR …”

Interictal epileptogenic zone localization in patients with focal epilepsy using electric source imaging and directed functional connectivity from low‐densityEEG

“…In patients with focal epilepsy that is refractory to antiepileptic drugs, epilepsy surgery can be a very efficient treatment. Therefore, the accurate location of the cortical areas to be removed by surgery (epileptogenic zone, EZ) is crucial.…”