Influence of different treatment time on the relapse and prognosis of patients with newly diagnosed epilepsy

Abstract

Objective To explore the influence of different treatment time on the relapse and prognosis of patients with newly diagnosed epilepsy. Methods To prospectively studied the clinical characteristics of 155 patients with newly diagnosed epilepsy. Patients were separated into immediate ( n =84, seizures ≤3 times) or deferred (n =71, seizures ＞ 3 times) treatment groups according to number of seizures before treatment with appropriate antiepileptic drugs (AEDs). The patients were followed up for at least one year (median, 29 months). Kaplan-Meier survival statistics was used to analyze time to first seizure or time to treatment failure (inadequate seizure control and (or) intolerable side-effects ). The proportions of patients with treatment failure and seizure free during follow up were also compared. Results There was no significant difference in time to first seizure or time to treatment failure between immediate ( 1484 days and 2992 days) and deferred treatment ( 1104 days and 1964 days; Log-Rank test x2 =0. 571 and 0. 018 respectively, P = 0. 450 and 0. 893 ). Subgroup analyses according to etiology ( primary and cryptogenic/symptomatic epilepsy) and age (children ≤ 16 years; adult ＞ 16 years) did not reveal any difference between immediate and deferred treatment. During follow up, there were 20 treatment failure patients ( 23. 8% ) in immediate treatment group and 16 ( 22.5% ) in deferred treatment group ( no statistical difference, x2 =0. 035 ,P =0. 852). There were 40 seizure free patients (47. 6% ) in immediate treatment group and 30 (42. 3% ) in deferred treatment group ( no statistical difference, x2 = 0. 447, P =0. 504 ). Conclusions For newly diagnosed epilepsy patients with a few seizures ( seizures ≤ 3 ), immediate AEDs treatment does not affect the relapse and prognosis. Key words: Epilepsy; Drug therapy; Recurrence; Prognosis