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

Bell, Gail S.; Neligan, Aidan; Giavasi, Christina; Keezer, Mark R; Nový, Jan; Peacock, Janet L.; Johnson, Anthony L.; Goodridge, D; Shorvon, Simon; Sander, Josemir W.

doi:10.1136/jnnp-2015-312314

Cited by 59 publications

(26 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a recent retrospective Italian population study of 747 subjects of all ages with either prevalent or incident epilepsy, during follow‐up of 20 years, 50% had started a period of 5‐year remission and 43% were in sustained or terminal remission . In a recent prospective observational general‐practitioner–based cohort study from the United Kingdom, 318 people with incident epilepsy were followed for 25 years. Five‐year remission ever was achieved by 81% and 5‐year terminal remission by 80% of 178 subjects with complete follow‐up.…”

Section: Discussionmentioning

confidence: 99%

Remission in epilepsy: How long is enough?

Sillanpää

Schmidt²,

Saarinen

et al. 2017

Epilepsia

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Remission in epilepsy: How long is enough?

Sillanpää

Schmidt²,

Saarinen

et al. 2017

Epilepsia

View full text Add to dashboard Cite

show abstract

“…That seizure frequency and cortical thinning may be separable processes adds to important epidemiological evidence that seizure frequency is not the only contributor to morbidity in people with a history of epilepsy. 5 Microglia are already known to have many roles in specific types of epilepsy, demonstrated clearly in a variety of animal models. Such roles include phagocytosis, which may link consumption of synapses with cognitive changes in long-term active epilepsy, 42 providing another possible mechanism for actual loss of brain volume in epilepsy: 'time is brain' 43 .…”

Section: Discussionmentioning

confidence: 99%

A systems-level analysis highlights microglial activation as a modifying factor in common forms of human epilepsy

Altmann

Ryten

et al. 2018

Preprint

View full text Add to dashboard Cite

The common human epilepsies are associated with distinct patterns of reduced cortical thickness, detectable on neuroimaging, with important clinical consequences. To explore underlying mechanisms, we layered MRI-based cortical structural maps from a large-scale epilepsy neuroimaging study onto highly spatially-resolved human brain gene expression data, identifying >2,500 genes overexpressed in regions of reduced cortical thickness, compared to relatively-protected regions. The resulting set of differentially-expressed genes shows enrichment for microglial markers, and in particular, activated microglial states.Parallel analyses of cell-specific eQTLs show enrichment in human genetic signatures of epilepsy severity, but not epilepsy causation. Post mortem brain tissue from humans with epilepsy shows excess activated microglia. In an experimental model, depletion of activated microglia prevents cortical thinning, but not the development of chronic seizures. These convergent data strongly implicate activated microglia in cortical thinning, representing a new dimension for concern and disease modification in the epilepsies, potentially distinct from seizure control.

show abstract

“…Furthermore, patients not satisfied with our treatment due to ongoing seizures, adverse events or both and deaths during the past period of at least 25 years were not covered by this cross-sectional study. Mortality is clearly increased in adult patients with difficult-to-treat epilepsy syndromes [16,17] and even in patients with seizures in remission and without antiepileptic drug treatment [9].…”

Section: Discussionmentioning

confidence: 99%

The General and Social Health Long-Term Outcome of Adult Epilepsy Patients at the Kork Epilepsy Center

Burkhardt

Bacher

Kornmeier

et al. 2018

Neurology International Open

View full text Add to dashboard Cite

Objectives The majority of epidemiological studies show that there is an increased burden of somatic comorbidities among people with epilepsy (PWE) compared with the general population. We sought that in the subgroup of patients with satisfactory and stable seizure situation and healthy style of living, the general health and quality of life might be similar to people without epilepsy and investigated the long-term outcome and the prevalence of comorbidities and the social outcome of adult patients who had been continuously treated at our center for at least 25 years. Material and methods We consecutively collected our adult out-patients for 10 months and identified those patients who had been treated at our center for at least 25 years. Among this group we assessed demographic data, epilepsy syndrome, seizure situation, antiepileptic therapy, the number of previous AEDs, the socioeconomic situation and co-morbidities. Results Out of a total of 1672 patients, 14.4 % (n = 241) patients fulfilled our inclusion criterion. In 200 the files allowed an appropriate analysis of the data. Mean treatment duration in Kork was 36 years (25 – 52). 60% of patients were seizure-free for more than one year. 80% of the seizure-free patients did not complain of adverse events. Adverse events were more often among patients with ongoing seizures. Somnolence, gait disturbances and tremor were the leading symptoms. Better seizure outcome correlated with higher education, better professional education and lower unemployment rates. Diseases such as cardiovascular diseases or diabetes mellitus were not more frequent than in the general population. PWE do not have necessarily an impaired prognosis of their general health.

show abstract

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

Cited by 59 publications

References 27 publications

Remission in epilepsy: How long is enough?

Remission in epilepsy: How long is enough?

A systems-level analysis highlights microglial activation as a modifying factor in common forms of human epilepsy

The General and Social Health Long-Term Outcome of Adult Epilepsy Patients at the Kork Epilepsy Center

Contact Info

Product

Resources

About