Abstract
Objective:The aim of this study was to investigate the effect of demographic and clinical characteristics on temporal changes in seizure control and frequency in medically treated epilepsy patients to guide treatment modalities.Methods:We retrospectively analyzed the association between clinical and demographic characteristics and seizure frequency in 1329 epilepsy patients who were followed up at an outpatient clinic for one to eight years, 2008-2015..Results:Younger age at first seizure (p = 0.0465) and a long disease duration (p = 0.0406) had a negative effect on seizure control in all the epilepsy patients. Febrile convulsions (FCs) (p > 0.0001), perinatal risk (PNR) (p > 0.0002), a family history of epilepsy (FHE) (p > 0.0016), antiepileptic drug (AED) use (p > 0.001), mental retardation (MR) (p > 0.001), and psychiatric disorders (p > 0.0478) were prognostic indictors of temporal changes in seizure frequency. The presence of PNR (p = 0.0416), age at onset of epilepsy (p = 0.034), central nervous system infection (CNSI) (p = 0.04), and AEDs number (p = 0.0282) were prognostic indicators of not remaining seizure free for one year. In those with partial epilepsy, a trauma history (p = 0.05), a longer epilepsy duration (p = 0.0057), and FHE (p = 0.0466) increased the frequency of seizures, whereas cerebrovascular event (CVE) history decreased the seizure frequency (p = 0.0413). In addition, FHE (p = 0.0438) and psychotic disorders (p = 0.0416) increased generalized seizures frequency.Conclusion:In all the epilepsy patients, a younger age at onset and longer duration of epilepsy were associated with a poor prognosis. The presence of PNR, age at onset of epilepsy, CNSI, and AEDs numbers were prognostic indicators of not remaining seizure free for one year. Increasing AEDs number was not effective in controlling seizures in partial epilepsy, but it was effective in controlling seizures in generalized epilepsy.
Highlights
Epilepsy is a common neurological disorder worldwide.[1]
Younger age at epilepsy onset and a longer duration of epilepsy were associated with a worse prognosis in all the epilepsy patients
family history of epilepsy (FHE), duration of epilepsy, trauma, and cerebrovascular event (CVE) resulted in temporal changes in seizure control
Summary
Epilepsy is a common neurological disorder worldwide.[1] Information on the patient’s prognosis is necessary to prevent unnecessary drug use. There are only a few reports on the prognostic factors in patients with medically treated epilepsy.[2,3] the number of patients, evaluated risk factors, and follow-up of the patients were very limited in these reports. No published studies have investigated temporal changes in factors that can affect the prognosis of epilepsy patients. The present study retrospectively studied the effects of demographic and clinical characteristics of epileptic patients treated medically on temporal changes in the frequency of seizures during an eight-year follow-up study
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