Ahead of print
Research paper
Published online: 2020-07-27
Submitted: 2020-03-19
Accepted: 2020-07-17
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Predictors of remission in patients with epilepsy

Kamil Wężyk, Agnieszka Słowik, Magdalena Bosak
DOI: 10.5603/PJNNS.a2020.0059
·
Pubmed: 32757204

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Ahead of print
Research paper
Published online: 2020-07-27
Submitted: 2020-03-19
Accepted: 2020-07-17

Abstract

Aim of study. To evaluate the rate and factors predicting seizure remission in a large cohort of patients with epilepsy.

Materials and methods. Patients with epilepsy treated at a university epilepsy clinic were included in this study. The following information was collected by means of a structured questionnaire: age, sex, age at onset of epilepsy, aetiology of epilepsy, the presence of intellectual disability, duration and type of epilepsy, frequency of seizures, treatment of epilepsy, and mechanism of action of antiepileptic drugs (AEDs).

Results. A total of 530 adult patients participated in this study (mean age ± standard deviation: 36.1 ± 12.6 years). Of these, 327 (61.7%) were female, and 364 (68.7%) patients had focal epilepsy. Twelve-month seizure freedom was achieved in 246 (46.4%) patients. Logistic regression revealed several independent predictors of seizure freedom: younger age (odds ratio (OR) = 0.98; p = 0.037), male sex (OR = 1.54; p = 0.050), generalised epilepsy (OR = 1.61; p = 0.052), lower number of prescribed AEDs (OR = 0.22; p = 0.001), and taking a combination of valproate and lamotrigine (OR = 2.51; p = 0.024).

Conclusions. Most patients with epilepsy enter remission on monotherapy with their first or second AED. However, a substantial proportion of patients may benefit from combination therapy including valproate and lamotrigine polytherapy.

Abstract

Aim of study. To evaluate the rate and factors predicting seizure remission in a large cohort of patients with epilepsy.

Materials and methods. Patients with epilepsy treated at a university epilepsy clinic were included in this study. The following information was collected by means of a structured questionnaire: age, sex, age at onset of epilepsy, aetiology of epilepsy, the presence of intellectual disability, duration and type of epilepsy, frequency of seizures, treatment of epilepsy, and mechanism of action of antiepileptic drugs (AEDs).

Results. A total of 530 adult patients participated in this study (mean age ± standard deviation: 36.1 ± 12.6 years). Of these, 327 (61.7%) were female, and 364 (68.7%) patients had focal epilepsy. Twelve-month seizure freedom was achieved in 246 (46.4%) patients. Logistic regression revealed several independent predictors of seizure freedom: younger age (odds ratio (OR) = 0.98; p = 0.037), male sex (OR = 1.54; p = 0.050), generalised epilepsy (OR = 1.61; p = 0.052), lower number of prescribed AEDs (OR = 0.22; p = 0.001), and taking a combination of valproate and lamotrigine (OR = 2.51; p = 0.024).

Conclusions. Most patients with epilepsy enter remission on monotherapy with their first or second AED. However, a substantial proportion of patients may benefit from combination therapy including valproate and lamotrigine polytherapy.

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Keywords

epilepsy, remission, polytherapy, monotherapy, mechanism of action

About this article
Title

Predictors of remission in patients with epilepsy

Journal

Neurologia i Neurochirurgia Polska

Issue

Ahead of print

Published online

2020-07-27

DOI

10.5603/PJNNS.a2020.0059

Pubmed

32757204

Keywords

epilepsy
remission
polytherapy
monotherapy
mechanism of action

Authors

Kamil Wężyk
Agnieszka Słowik
Magdalena Bosak

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