Prognostic analysis for short- and long-term outcomes of newly diagnosed epilepsy

Abstract

Purpose: To explore predictors for short- and long-term prognosis of newly diagnosed epilepsy.

Methods: 549 consecutive patients with newly diagnosed epilepsy were reviewed, 336 were enrolled in the study. Two-year remission in the short term (5 years) and five-year remission in the long term (>5, up to 8 years) were assessed as the outcomes. Logistic regression was used to identify independent predictors for unfavorable outcomes. χ² test was used to compare the retention rates of old and new antiepileptic drugs (AEDs).

Results: 185 patients (55%) attained two-year remission in the short term, 163 (48.5%) attained terminal remission in the long term. The time interval between index seizure and AED start >12 months implied an unfavorable outcome in the short term (OR=1.9, p=0.03). Two or more seizures in the first year after AED start showed the strongest negative prognostic impact in the both short- and long-term outcomes (OR=2.3, p=0.02; OR=1.9, p=0.03). As the seizure frequency rose, the possibility for unfavorable outcome increased. The terminal retention rates of traditional and new AEDs were not significantly different (p=0.07).

Conclusions: For patients with newly diagnosed epilepsy, the time interval between index seizure and AED start only influences the short-term outcome. Number of seizures in the first year after AED start is associated with both short- and long-term outcomes. It's imperative to initiate adequate, tolerated and appropriately chosen AED schedules after the definitive diagnosis of epilepsy.

Keywords: Cohort study; Newly diagnosed epilepsy; Prognosis; Retention rates; Seizure frequency.