title: Factors predicting prognosis of epilepsy after presentation with seizures.
abstract: The objective of this study was to identify the factors, at the time of diagnosis, that determine the prognosis for remission of epilepsy. A prospective community-based cohort study of 792 patients recruited at the time of their first diagnosis of epileptic seizures was undertaken; in those classified 6 months after presentation, the median follow-up period was 7.2 years (quartiles at 6.2 and 8.2 years) after presentation. We analyzed data from 6 months after the first identified seizure, which prompted the diagnosis of epilepsy, to allow us to factor in those aspects contingent on a diagnostic assessment Baseline clinical and demographic data were analyzed using the Cox proportional hazards regression model with remission of epilepsy for 1, 2, 3, and 5 years as outcome measures. The dominant clinical feature predicting remission was the number of seizures in the 6-month diagnostic assessment period. Thus, the chance of entering 1 year of remission by 6 years for a patient who had 2 seizures during this initial 6 months was 95%; for 5 years of remission, it was 47% as opposed to 75% for 1 year of remission and 24% for 5 years of remission if there had been 10 or more seizures during this period. The number of seizures in the early phase of epilepsy (here, taken as the first 6 months after presentation) is the single most important predictive factor for both early and long-term remission of seizures.
authors: Institute of Neurology, National Hospital of Neurology and Neurosurgery, London, UK.
authors: B K
authors: BK
authors: MacDonald
authors: A L
authors: AL
authors: Johnson
authors: D M
authors: DM
authors: Goodridge
authors: O C
authors: OC
authors: Cockerell
authors: J W
authors: JW
authors: Sander
authors: S D
authors: SD
authors: Shorvon
mesh_terms: D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis