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Positive response to medication does not ensure good prognosis

29 Jan 2003

Early successful treatment and control of seizures with appropriate medications does not necessarily guarantee that seizures will always be controlled by those medications in the future, according to a study published in the journal Neurology.

The study examined 333 adults with epilepsy who underwent surgery for partial epilepsy occurring in a localised area of the brain. The study found that the patients went an average of nine years from the start of their epilepsy to the point when their epilepsy was intractable, or could no longer be controlled by medication. Intractable epilepsy was defined as the failure of two medications to control seizures.

The study also found that 26 per cent of the patients had a remission period without any seizures of at least a year before having surgery. Remission periods of five years or more were reported by 8.5 per cent of the patients. The younger patients were when their epilepsy started, the more likely they were to have had a remission period and the longer the time was between when the epilepsy started and when it became intractable.

Study author Dr Anne T. Berg, of Northern Illinois University in DeKalb, noted that the results need to be confirmed by additional studies:

"The possibility that an early positive response to treatment may not necessarily guarantee a good long-term outcome is sobering news, but it's possible that we could learn to identify those patients who will develop intractable epilepsy in the future, identify the mechanisms involved and eventually develop treatments that might prevent some forms of epilepsy from becoming intractable."