Influences of immediate versus deferred treatment with antiepileptic drugs on relapse of epilepsy in newly diagnosed patients

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Author:
SU Ling-ying(Department of Neurology, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China)
DI Qing(Department of Neurology, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China)
Journal Title:
CHINESE JOURNAL OF NEUROMEDICINE
Issue:
Volume 10, Issue 04, 2011
DOI:
10.3760/cma.j.issn.1671-8925.2011.04.004
Key Word:
Epilepsy;Antiepileptic drug;Relapse

Abstract: Objective To explore the influences of immediate and deferred treatment with antiepileptic drugs (AEDs) on relapse of epilepsy in newly diagnosed patients. Methods The clinical data of newly diagnosed epileptic patients were collected prospectively and the patients were divided into immediate (seizures≤2) and deferred (seizures>2) treatment groups according to times of seizures before treatment; these patients were treated with antiepileptic drugs reasonably. The patients were followed up for at least 2 years. Kaplan-Meier statistics was used to analyze the times to the first and second seizures after treatment. We also observed and compared their cumulative recurrence rate during the follow-up.Results One hundred and sixty-two patients were collected, 65 of which were in the immediate treatment group and 97 of which were in the deferred treatment group; The patients were followed up for 2-14 years(median 3 years). Times to the first and second seizures in the immediate treatment group were significantly longer than those in the deferred treatment group (x2=5.394, P=0.020; x2=7.210, P=0.007,respectively). Till the end of follow-up, 58.5% patients relapsed in the immediate treatment group, which was lower than that in the deferred treatment group (72.2%), but no statistical difference was noted (x2=3.289, P=0.07). The cumulative recurrence rates in the immediate and deferred treatment groups were 16.9% vs. 35.1% (x2=6.376, P=0.012), 26.2% vs. 48.5% (x2=8.098, P=0.004), 41.5% vs. 56.7% (x2=3.580,P=0.058) and 50.8% vs. 64.9% (x2=3.241, P=0.072) in the 3rd, 6th, 12th and 24th month of follow-up.Conclusion Immediate treatment with AEDs could reduce early recurrence rate of epilepsy in newly diagnosed epileptic patients with a few seizures (seizures ≤2).

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