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. 2017 Dec 8:8:658.
doi: 10.3389/fneur.2017.00658. eCollection 2017.

Initial Response to Antiepileptic Drugs in Patients with Newly Diagnosed Epilepsy As a Predictor of Long-term Outcome

Lu Xia  1 , Shuchun Ou  1 , Songqing Pan  1
Affiliations

Initial Response to Antiepileptic Drugs in Patients with Newly Diagnosed Epilepsy As a Predictor of Long-term Outcome

Lu Xia et al. Front Neurol. .

Abstract

Objective: To investigate the correlation between initial response to antiepileptic drugs (AEDs) and long-term outcomes after 3 years in patients with newly diagnosed epilepsy.

Methods: This prospective study included 204 patients with newly diagnosed epilepsy, who were followed-up for at least 36 months. The long-term seizure freedom at 36 months (36MSF) was evaluated in patients with seizure freedom 6 months (6MSF) or 12 months (12MSF) after initial treatment vs those with no seizure freedom after the initial 6 months (6MNSF) or 12 months (12MNSF). Univariate analysis and a multiple logistic regression model were used to analyze the association of potential confounding variables with the initial response to AEDs.

Results: The number of patients with 36MSF was significantly higher for patients that had 6MSF (94/131, 71.8%) than those that had 6MNSF [16/73, 21.9%; χ2 = 46.862, p < 0.0001, odd ratio (OR) = 9.051]. The number of patients with 36MSF was significantly higher in patients that had 12MSF (94/118 79.7%) than those that had 12MNSF (19/86, 22.1%; χ2 = 66.720, p < 0.0001, OR = 13.811). The numbers of patients that had 36MSF were not significantly different between patients that experienced 6MSF and 12MSF or between patients that had 6MNSF and 12MNSF. Abnormalities observed in magnetic resonance imaging or computed tomography and the number of seizures before treatment correlated with poor initial 6-month response to AEDs.

Significance: The initial 6-month response to AEDs is a valuable predictor of long-term response in patients with newly diagnosed epilepsy. The number of seizures before treatment and brain-imaging abnormalities are two prognostic predictors of initial 6-month seizure freedom.

Keywords: antiepileptic drugs; brain-imaging abnormalities; early response; long-term outcome; pretreatment seizure numbers.

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Figures

Figure 1
Figure 1
Forest plot of long-term seizure freedom rates with modified Wald method 95% confidence interval (CI) for patients with 6MSF vs 12MSF (orange) and 6MNSF vs 12MNSF (blue). Overlapping CIs indicate no different long-term seizure freedom rates between 6MSF vs 12MSF and 6MNSF vs 12MNSF.
Figure 2
Figure 2
Kaplan–Meier survival analysis of the time until the first seizure recurrence during antiepileptic drug treatment against the number of seizures before treatment (A) and brain-imaging results (B).
See this image and copyright information in PMC

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