Prognostic analysis for short- and long-term outcomes of newly diagnosed epilepsy.
OBJECTIVE
To explore predictors for short- and long-term prognosis of newly diagnosed epilepsy.


METHODS
549 consecutive patients with newly diagnosed epilepsy were reviewed, 336 were enrolled in the study. Two-year remission in the short term (5 years) and five-year remission in the long term (>5, up to 8 years) were assessed as the outcomes. Logistic regression was used to identify independent predictors for unfavorable outcomes. χ2test was used to compare the retention rates of old and new antiepileptic drugs (AEDs).


RESULTS
185 patients (55%) attained two-year remission in the short term, 163 (48.5%) attained terminal remission in the long term. The time interval between index seizure and AED start >12 months implied an unfavorable outcome in the short term (OR=1.9, p=0.03). Two or more seizures in the first year after AED start showed the strongest negative prognostic impact in the both short- and long-term outcomes (OR=2.3, p=0.02; OR=1.9, p=0.03). As the seizure frequency rose, the possibility for unfavorable outcome increased. The terminal retention rates of traditional and new AEDs were not significantly different (p=0.07).


CONCLUSIONS
For patients with newly diagnosed epilepsy, the time interval between index seizure and AED start only influences the short-term outcome. Number of seizures in the first year after AED start is associated with both short- and long-term outcomes. It's imperative to initiate adequate, tolerated and appropriately chosen AED schedules after the definitive diagnosis of epilepsy.
Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China.
Yong-Li
YL
Jiang
Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China.
Fang
F
Yuan
Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China.
Fang
F
Yang
Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China.
Xiao-Long
XL
Sun
Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China.
Xi-Ai
XA
Yang
Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China.
Lu
L
Song
Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China. Electronic address: jiangwen@fmmu.edu.cn.
Wen
W
Jiang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D000927:Anticonvulsants
Cohort study; Newly diagnosed epilepsy; Prognosis; Retention rates; Seizure frequency