Refractory epilepsy in a Chinese population

Hui, Andrew; Wong, Adrian; Wong, Ho‐Fai; Man, Bik Ling; Au-Yeung, K.M.; Wong, Ka Sing

doi:10.1016/j.clineuro.2007.05.016

Cited by 20 publications

(18 citation statements)

References 24 publications

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“…While the risk factors influencing the prognosis of epilepsy have begun to be appreciated [4-7], limited data are available on the clinical patterns of treatment response in newly diagnosed epilepsy. It is important to understand the different clinical patterns of response to AED treatment, ideally by following the outcomes once the treatment has been initiated.…”

Section: Introductionmentioning

confidence: 99%

A prospective cohort study of prognosis for newly diagnosed epilepsy in east China

Zhang

et al. 2013

BMC Neurol

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BackgroundLimited data are available on the outcome of antiepileptic drug treatment response in patients of Chinese Han ethnicity with newly diagnosed epilepsy. We sought to explore the prognosis with antiepileptic drug treatment and to identify the predictors of poor drug control of seizures in these patients.MethodsFor at least 2 years, we prospectively followed up a cohort of patients with newly diagnosed epilepsy and analyzed the response to each antiepileptic drug. Cumulative risk for seizure relapse after initial remission achieved was estimated. The patients were divided into two groups (poor and good control) and compared for clinical characteristics.ResultsA total of 180 patients were included. Early remission was reached in 125 (69.44%) patients, 19 (10.56%) patients entered late remission, while 36 (20%) patients failed to achieve remission. The relapse rates were 19.5% at 2 years and 31.9% at 3 years of the follow-up. The response rates of the first throughout the fourth treatment regimens were 60.0%, 16.1%, 2.8%, and 0.6%, respectively. Multiple seizure types and changes in seizure type during treatment were significantly (p = 0.013 and 0.047, respectively) associated with a poor control.ConclusionsThe prognosis of the majority of patients with newly diagnosed epilepsy is good and the clinical pattern of epilepsy during treatment is complex. The chances of seizure control declines with each subsequent treatment regimen. The prognosis for patients with multiple seizure types and seizure type changes during treatment is unfavorable.

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Section: Introductionmentioning

confidence: 99%

A prospective cohort study of prognosis for newly diagnosed epilepsy in east China

Zhang

et al. 2013

BMC Neurol

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“…However, the symptomatic etiology is more frequent in the group with RE -in 28 (40%) cases. There is a concencus in the scientific literature about the high frequency of the symptomatic etiology in the first place and of the cryptogenic etiology in the second place in patients with RE [2,4,6,7,9,11,12,15,16,19,22,23,27,28,30,35,36,37]. De Saint-Martin and Hirsch (2004) have determined the risk for RE development depending on the etiology and the type of epileptic syndrome -increased (34.6%) in cases with a generalized symptomatic or a cryptogenic syndrome, moderate -in patients with a partial symptomatic or a cryptogenic (10.6%) and an unclassified syndrome (10.4%), low -in patients with an idiopathic syndrome (2.7%) [15].…”

Section: American Journal Of Clinical Medicine Researchmentioning

confidence: 99%

Predictors and Typical Clinical Findings of Refractory Epilepsy

Viteva¹

2014

AJCMR

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“…The vast majority of patients are treated with antiepileptic drugs (AEDs), and approximately 70% can become seizure-free with AEDs alone (Eatock and Baker, 2007). Approximately one third of patients, however, continue to experience seizures despite multiple AEDs prescribed at appropriate doses (Hui et al, 2007). For these drugrefractory epilepsy patients, surgery has been demonstrated to be a safe and effective treatment, and surgically treated patients achieve significantly higher rates of seizure-free status compared to drug-refractory patients who have not been treated surgically (Yasuda et al, 2006).…”

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confidence: 99%

Factors influencing medication adherence after epilepsy surgery

Liu

et al. 2015

Epileptic Disorders

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Aim. In drug‐responsive epilepsy patients, treatment non‐compliance is a major factor in seizure recurrence, but adherence to prescribed regimens following epilepsy surgery has not been examined. We measured adherence to prescribed antiepileptic drugs (AEDs) after epilepsy surgery and investigated factors influencing treatment non‐compliance. Methods. Postsurgical epilepsy patients (n=214) were monitored for 18.1±8.1 months. Adherence was measured using the Medication Possession Ratio (MPR) self‐report questionnaire, with MPR<0.8 defined as non‐adherence. Results. According to the MPR, 58 patients (27.1%) were non‐adherent after surgery. There were no differences in demographic and clinical variables, such as age (p=0.057, t =−1.925), duration of illness (p=0.597, t=0.530), gender ratio (p=0.714, χ2=0.134), and place of residence (urban vs. rural; p=0.874, χ2=0.025), between adherent and non‐adherent patients. Moreover, adherence was not related to surgical outcome as evaluated by the Engel classification (p=0.635, χ2=1.628) or to the types of AEDs after surgery (p=0.165, χ2=6.530). The most common reasons for non‐adherence were seizure‐free status for an extended period (26.5%), forgetfulness (19.1%), and an inability to buy the drugs locally (18.6%). Conclusion. Adherence to AEDs is improved after epilepsy surgery compared to presurgical estimates, but is still a common and serious problem. Targeted postsurgical management programs and communication strategies are necessary to improve adherence to AEDs after epilepsy surgery.

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Refractory epilepsy in a Chinese population

Cited by 20 publications

References 24 publications

A prospective cohort study of prognosis for newly diagnosed epilepsy in east China

A prospective cohort study of prognosis for newly diagnosed epilepsy in east China

Predictors and Typical Clinical Findings of Refractory Epilepsy

Factors influencing medication adherence after epilepsy surgery

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