Prognostic analysis for short- and long-term outcomes of newly diagnosed epilepsy

- Time interval between index seizure and AED start is associated with short term outcome, while it does not influence long term outcome.
- The number of seizures ≥2 in the first year after AED start is the independent risk factor for both short and long term outcome.
- No significant difference of retention rate was found between the traditional and new AEDs in patients who attained terminal remission.

PurposeTo explore predictors for short- and long-term prognosis of newly diagnosed epilepsy.Methods549 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. χ2 test was used to compare the retention rates of old and new antiepileptic drugs (AEDs).Results185 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).ConclusionsFor 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.