Treatment of the first tonic-clonic seizure does not affect long-term remission of epilepsy.
We followed 419 patients with a first, unprovoked, primarily or secondarily generalized tonic-clonic seizure, randomized to immediate antiepileptic treatment or to treatment only in the event of seizure recurrence. The probability of achieving a 2-year remission was 72 vs 57% at 3 months, 84 to 79% at 3 years, and 85 to 86% at 10 years (p = NS). The probability of entering 5-year remission was 47 to 40, 58 to 58, and 64 to 64% (p = NS). Early treatment does not affect the long-term prognosis of epilepsy.
Leone
Maurizio A
MA
Clinica Neurologica, Ospedale Maggiore della Carità, C.so Mazzini, 18-28100 Novara, Italy. maurizio.leone@maggioreosp.novara.it
Solari
Alessandra
A
Beghi
Ettore
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004830:Epilepsy, Tonic-Clonic / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D011379:Prognosis; D012075:Remission, Spontaneous; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome
D000927:Anticonvulsants