title: Prognosis after late relapse following epilepsy surgery.
abstract: OBJECTIVE
  To assess prognosis after late relapse in patients who are seizure free for the first 5 years after epilepsy surgery.
  
  
  METHODS
  Patients who were seizure free for the first 5 years after resective epilepsy surgery were included. Date of first seizure recurrence, current seizure status, medication, age, and type of surgery were prospectively registered. Non-parametric statistics were used.
  
  
  RESULTS
  One hundred and fifty-nine patients were studied. Thirty-two had at least one recurrent seizure. Time to event analysis showed an annual relapse rate of 4% between years 5 and 10 after surgery. At study termination, 143 of 159 patients (89.9%) were in terminal remission. For 30 patients with late relapse and at least 1-year follow-up thereafter, 53% were in terminal remission and 30% had experienced only rare or nocturnal seizures. Medication use was not associated either with likelihood of relapse or entering remission after relapse.
  
  
  CONCLUSIONS
  Patients who are seizure free for the first 5 years after epilepsy surgery remain at risk for seizure recurrence. These relapses are often isolated events, and the long-term prognosis after relapse is often good. Relapse rates were similar in patients on and off AEDs, but the relation between AED taper and relapse is uncertain since patient groups may not be similar.
authors: Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA 19107, United States. michael.sperling@jefferson.edu
authors: Michael R
authors: MR
authors: Sperling
authors: Maromi
authors: M
authors: Nei
authors: Andro
authors: A
authors: Zangaladze
authors: Ashwini D
authors: AD
authors: Sharan
authors: Scott E
authors: SE
authors: Mintzer
authors: Christopher
authors: C
authors: Skidmore
authors: James G
authors: JG
authors: Evans
authors: Courtney A
authors: CA
authors: Schilling
authors: Ali A
authors: AA
authors: Asadi-Pooya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D004827:Epilepsy / Q000175:diagnosis / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants