title: The long-term prognosis of newly diagnosed epilepsy in Egypt: A retrospective cohort study from an epilepsy center in Greater Cairo.
abstract: OBJECTIVE
  To investigate the long-term prognosis and prognostic patterns of epilepsy in a single practice study from a developing country.
  
  
  METHODS
  Consecutive patients first seen in an epilepsy clinic in Cairo, Egypt between January 1994 and December 2009 with at least 4 years of follow-up were included. Demographic, clinical, EEG and imaging findings at diagnosis were recorded. At follow-up, treatment was adjusted as clinically indicated. The response to the first drug was defined as 6-month seizure remission. Outcome measures included 2-year remission (R) and 2-year sustained remission (SR). Prognostic patterns were early (ER) and late remission (LR), relapsing-remitting (RR) course, worsening course (WC) and no remission.
  
  
  RESULTS
  Included were 287 patients aged 1-66 years and followed for 2237.0 person-years (mean 7.8 years). 244 (85%) attained 2-year R. The cumulative time dependent probability of R was 86.7% at 10 years. Only the response to the first drug predicted R. 82 (28.6%) attained 2-year SR. The probability of SR was 40.9% at 10 years. Poor treatment response and nocturnal seizures predicted lowered SR. R and SR were inversely correlated to the number of drugs. 208 patients (72.5%) entered ER, 36 (12.5%) entered LR, 138 (48.1%) had RR course. A WC was present in 24 (8.4%), 43 (15.0%) never entered remission. Prognostic patterns varied with neurological examination, MRI findings, pre-treatment seizure frequency, seizure type, number of seizure types, etiology, syndrome and response to first drug.
  
  
  CONCLUSIONS
  The long-term prognosis of newly diagnosed epilepsy patients from a developing country is in keeping with published reports.
authors: Epiclue Epilepsy Clinic, Cairo, Egypt. Electronic address: aymaneuro@hotmail.com.
authors: Ayman
authors: A
authors: Ashmawi
authors: Epiclue Epilepsy Clinic, Cairo, Egypt; Department of Neurology, Cairo University, Egypt. Electronic address: drhassanhosny@yahoo.com.
authors: Hassan
authors: H
authors: Hosny
authors: Department of Neurology, Cairo University, Egypt. Electronic address: a.aalim@kasralainy.edu.eg.
authors: Ahmed
authors: A
authors: Abdelalim
authors: IRCCS - Istituto Mario Negri, Milano, Italy. Electronic address: elisa.bianchi@marionegri.it.
authors: Elisa
authors: E
authors: Bianchi
authors: IRCCS - Istituto Mario Negri, Milano, Italy. Electronic address: ettore.beghi@marionegri.it.
authors: Ettore
authors: E
authors: Beghi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D004534:Egypt / Q000453:epidemiology; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014505:Urban Population; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Drug treatment; Newly diagnosed epilepsy; Prognosis; Prognostic predictors; Relapse; Remission