title: Therapeutic response of absence seizures in patients of an epilepsy clinic for adolescents and adults.
abstract: Responses of seizures to therapy is one of the most important prognostic factors in epilepsy. Absences are among the seizure types with a good response to antiepileptic drug treatment and, usually, remission before adult age. Absence patients attending an epilepsy clinic for adults can be expected to represent a group with negative bias because they have not yet remitted. Furthermore, the majority have additional generalized tonic-clonic seizures, which is a recognized negative factor in prognosis. We studied 229 adolescents and adults who were under our care for at least 2 years, and divided them into three groups according to their becoming absence free for at least 1 year: (1) responders to simple therapy (one anti-absence drug in doses not exceeding 2 g/day); (2) responders to complex therapy (one anti-absence drug in higher dose or combination of anti-absence drugs); (3) non-responders. Groups 1 and 2 can be considered jointly as responders as opposed to the non-responder group. Similarly, groups 2 and 3 can be considered jointly as a group with poor as opposed to good therapeutic response. It was found that significant differences exist between good and poor responders, and 15 factors which had a negative effect on therapeutic response could be identified. No single factor or combination was responsible for non-response, but non-responders had the highest score of negative factors. Patients with complete absence control had a 93% chance of total seizure control, and, with constant medication, relapses after 1 year of control were very infrequent.(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy; D004832:Epilepsy, Absence / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010044:Outpatient Clinics, Hospital; D012008:Recurrence
chemical_list: D000927:Anticonvulsants