The likelihood that a patient with epilepsy will become seizure-free decreases with each new drug regimen, according to a study that was published in the May 15 issue of Neurology. The chance of seizure freedom decreases most dramatically between the first and the third drug regimens.
To study outcomes over time and calculate the probability of seizure freedom with successive antiepileptic drug regimens, M.J. Brodie, MD, of the Epilepsy Unit of Western Infirmary in Glasgow, and colleagues followed up 1,098 patients who had been diagnosed with epilepsy and prescribed a first AED between July 1982 and April 2006.
At the last clinic visit in 2008, 68% of patients had been seizure-free for at least a year, and 62% were on monotherapy. Seizure freedom was early and sustained for 37% of patients, but 25% of patients never attained seizure freedom.
“A person who doesn’t respond well to two courses of epilepsy drug treatment should be further evaluated to verify an epilepsy diagnosis and to identify whether surgery is the best next step,” stated Patricia E. Penovich, MD, a neurologist at the Minnesota Epilepsy Group in St. Paul, and Michael Gruenthal, MD, Chair of the Department of Neurology at the Albany Medical Center in New York, in an accompanying editorial.
Brodie MJ, Barry SJE, Bamagous GA, et al. Patterns of treatment response in newly diagnosed epilepsy. Neurology. 2012;78(20):1548-1554.
Penovich PE, Gruenthal M. From patterns to patients: What can we tell people with newly diagnosed epilepsy? Neurology. 2012;78(20):1542-1543.