title: Long-term outcome in epilepsy with grand mal on awakening: forty years of follow-up.
abstract: Epilepsy with grand mal on awakening (EGMA) is a well-defined subtype of idiopathic generalized epilepsy. Patients with follow-up of at least 20 years were assessed retrospectively regarding 5-year terminal seizure remission. Forty-two patients were included (mean age=60 ± 13 years). After follow-up of 40 ± 13 years, 26 patients (62%) were in remission, 5 without antiepileptic drugs. Age at investigation (odds ratio=0.939, 95% confidence interval=0.887-0.994, p=0.029) independently predicted lacking remission. Nineteen patients (45.2%) had withdrawn from antiepileptic drugs at least once; 12 of those (63.2%) had seizure relapse. EGMA has a favorable long-term prognosis. With increasing age and treatment duration, antiepileptic drug withdrawal may be justified.
authors.affiliation: Epilepsy Center Berlin-Brandenburg, Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Holtkamp
authors.forename: Alexander B
authors.initials: AB
authors.lastname: Kowski
authors.forename: Hannah
authors.initials: H
authors.lastname: Merkle
authors.forename: Dieter
authors.initials: D
authors.lastname: Janz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012919:Social Behavior; D013226:Status Epilepticus / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants