Long‐term prognosis of epilepsy, prognostic patterns and drug resistance: a population‐based study. (23rd April 2016)

• Record Type: Journal Article
• Authors: Giussani, G.; Canelli, V.; Bianchi, E.; Erba, G.; Franchi, C.; Nobili, A.; Sander, J. W.; Beghi, E.
• Other Names: Agostoni Elio investigator.; Airoldi Larissa investigator.; Basso Francesco investigator.; Carpanelli Marialuisa investigator.; Stefano Mariolina Di investigator.; Magnoni Andrea investigator.; Martinelli Ottaviano investigator.; Rigamonti Andrea investigator.; Salmaggi Andrea investigator.; Stanzani Lorenzo investigator.; Volpe Cristina investigator.; Zanotta Nicoletta investigator.; Zucca Claudio investigator.; Agudio Marco investigator.; Arienti Flavio investigator.; Arrigoni Graziano Rocco investigator.; Balestra Giancarlo investigator.; Ballabio Piercarla investigator.; Balossi Stefano Marco investigator.; Baratti Maria Rita investigator.; Barteselli Fabrizia Enrica investigator.; Bellani Fausto investigator.; Bellani Mauro investigator.; Bellini Gianpiero investigator.; Beretta Pier Aldo investigator.; Beretta Roberto investigator.; Bergamini Massimo investigator.; Bertella Annalisa investigator.; Bertolini Francesco investigator.; Bevilacqua Rolando investigator.; Bianchi Marcellino Arturo investigator.; Bigiolli Patrizia investigator.; Binda Giuseppe investigator.; Biondelli Gigliola investigator.; Bodega Libero investigator.; Bolis Edoardo Giovanni investigator.; Bolla Marco Vincenzo Carlo investigator.; Bonacina Carlo Ambrogio investigator.; Bonfanti Marco investigator.; Borghetti Fausta investigator.; Brambilla Roberto investigator.; Brancaleone Wilma investigator.; Brusadelli Francesco investigator.; Bub Sabine investigator.; Caccia Giovanna investigator.; Caglio Myriam investigator.; Rossi Carlo Calvi investigator.; Capra Daniela investigator.; Carone Davide investigator.; Carì Giuseppe investigator.; Carrera Silvio investigator.; Cavenago Rosalia investigator.; Cecchetti Maria Luisa investigator.; Centonze Bice Antonella investigator.; Cereghini Fabio investigator.; Cerrone Ciro investigator.; Ciappetta Maria Pia investigator.; Cogliati Bruno investigator.; Colombano Ombretta investigator.; Colombo Alberto investigator.; Colombo Daniela investigator.; Corti Maria Lia investigator.; Cremonini Nicla investigator.; Crippa Marco investigator.; Crippa Rolando Antonio investigator.; Crotta Mario investigator.; Curto Salvatore investigator.; Daielli Patrizia investigator.; De Gilio Domenico investigator.; De Pascalis Giuseppe Pasquale investigator.; Decet Elena investigator.; Morte Luigi Della investigator.; Duvia Felice investigator.; Favorito Antonia investigator.; Ferrario Roberto investigator.; Fezzi Luigi investigator.; Finzi Angela Laura investigator.; Fiorentino Bruno Ugo investigator.; Fornaciari Agnese investigator.; Franceschetti Silvana investigator.; Fulconis Fabio investigator.; Fumagalli Giovanni investigator.; Fumagalli Maurizio investigator.; Galbiati Giuseppe investigator.; Galimberti Carlo Andrea investigator.; Gecchele Donatella investigator.; Ghiazza Barbara investigator.; Ghislanzoni Paolo investigator.; Gioffredi Laura investigator.; Hassibi Taraneh investigator.; Julita Simone investigator.; Leone Giuseppe investigator.; Levi Claudio investigator.; Locatelli Giovanni investigator.; Locati Anna Alessandra investigator.; Longhi Enrico Giovanni investigator.; Lukacova Ingrid investigator.; Manfroi Mauro Giovanni investigator.; Manzoni Paola investigator.; Marcolini Claudio investigator.; Minicucci Fabio investigator.; Martini Mohammed Safwan investigator.; Masperi Rita investigator.; Mayan Sussele investigator.; Mazzoleni Valeria investigator.; Menga Antonio investigator.; Merlini Fiorella investigator.; Messina Enrico investigator.; Micheli Marta investigator.; Micò Rocco investigator.; Millul Andrea investigator.; Montini Barbara investigator.; Palazzuolo Alberto investigator.; Panzeri Silvano Primo investigator.; Passoni Giovanni investigator.; Pensotti Laura investigator.; Petrone Maria Marcella investigator.; Pezzuto Roberto investigator.; Pigazzini Elisabetta investigator.; Pirovano Nicoletta investigator.; Pontiggia Margherita investigator.; Pozzi Roberto investigator.; Quadrelli Carlo investigator.; Rampello Filomena investigator.; Realini Marco investigator.; Righetti Giovanni investigator.; Ripa Cesare investigator.; Rivetta Sonia investigator.; Romeo Antonino investigator.; Rota Carlo investigator.; Rusconi Tiziana investigator.; Santarpia Andrea investigator.; Santi Ivana investigator.; Sciani Luigi investigator.; Scoccimarro Gianni investigator.; Scopinaro Eugenio investigator.; Semerano Angelo Giuseppe investigator.; Sferco Daniela investigator.; Sirtori Anna Ersilia investigator.; Spandri Angela investigator.; Spinelli Bruno investigator.; Stefanoni Fausto investigator.; Taiana Raffaele investigator.; Tamagnini Libero investigator.; Tassi Laura investigator.; Tentori Giorgio investigator.; Teodoro Augusto investigator.; Tinterova Katerina investigator.; Tocchetti Ampelio investigator.; Todeschini Michela investigator.; Trezza Lorenzo investigator.; Valsecchi Valter investigator.; Vanini Roberto investigator.; Vercelloni Claudio Felice investigator.; Villella Anna investigator.; Viola Maria investigator.; Vismara Pietro investigator.; Zoboli Daniele Mario investigator.; Bell Gail investigator.; Montesano Mariagrazia investigator.; Romi Silvia investigator.;
• Is Part Of: European journal of neurology. Volume 23:Number 7(2016:Jul.)
• Page Start: 1218
• Page End: 1227
• Publication Date: 2016-04-23
• Subjects: antiepileptic drug response -- chronic epilepsy -- drug resistance -- prognosis -- prognostic patterns; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.13005
• Languages: English
• ISSNs: 1351-5101

Abstract

Abstract : Background and purpose: Seizures in most people with epilepsy remit but prognostic markers are poorly understood. There is also little information on the long‐term outcome of people who fail to achieve seizure control despite the use of two antiepileptic drugs (drug resistance). Methods: People with a validated diagnosis of epilepsy in whom two antiepileptic drugs had failed were identified from primary care records. All were registered with one of 123 family physicians in an area of northern Italy. Remission (uninterrupted seizure freedom lasting 2 years or longer) and prognostic patterns (early remission, late remission, remission followed by relapse, no remission) were determined. Results: In all, 747 individuals (381 men), aged 11 months to 94 years, were followed for 11 045.5 person‐years. 428 (59%) were seizure‐free. The probability of achieving 2‐year remission was 18% at treatment start, 34% at 2 years, 45% at 5, 52% at 10 and 67% at 20 years (terminal remission, 60%). Epilepsy syndrome and drug resistance were the only independent predictors of 2‐ and 5‐year remission. Early remission was seen in 101 people (19%), late remission in 175 (33%), remission followed by relapse in 85 (16%) and no remission in 166 (32%). Treatment response was the only variable associated with differing prognostic patterns. Conclusion: The long‐term prognosis of epilepsy is favourable in most cases. Early seizure remission is not invariably followed by terminal remission and seizure outcome varies according to well‐defined patterns. Prolonged seizure remission and prognostic patterns can be predicted by broad syndromic categories and the failure of two antiepileptic drugs.