THE PROGNOSiS OF EPiLEPSY

The prognosis for full seizure control is relatively good. Studies have shown that about 70-80 per cent of all people developing epilepsy will eventually become seizure-free and about half will successfully withdraw their medication. Once a substantial period of remission has been achieved, the risk of further seizures is greatly reduced. A minority of patients (20-30 per cent) will develop


Chronic epilepsy, and in such cases treatment is more difficult. Patients with symptomatic epilepsy, more than one seizure type, associated learning difficulties, or neurological or psychiatric disorders are more likely to develop a chronic seizure disorder. Five per cent of patients with intractable epilepsy will be unable to live in the community or will be dependent on others for their day-today needs. In a minority of patients with severe epilepsy, physical and intellectual deterioration may occur.


The prognosis for AED withdrawal is worse in those who:

•  are 16 years or older;

•  are taking more than one AED;

•  have seizures after starting AEDs;

•  have a history of generalized tonic-clonic seizures or of myoclonus;

•  have an abnormal EEG.


Stopping treatment

Because of the possible long-term side-effects of the drugs, it is common clinical practice to consider drug withdrawal after a patient has had a substantial period of remission (usually two years). After this period of seizure freedom, the chance of successfully coming off medication is approximately 60 per cent. Even after being seizure-free for two years, there is still a chance of relapse while continuing the same medication; this chance of relapse is about half that of withdrawing medication.

A single mechanism) is still unknown. The annual mortality rate is one sudden death for every 1000 people with epilepsy in the community, but increase to one in 200 per year for those with refractory epilepsy and is more than 1 per cent per year for those referred to surgical programmes. Another possible cause of mortality and morbidity in people with epilepsy is as a result of accidents during seizures or as a consequence of a seizure. Mortality rates for traumatic death have been shown to be increased, indicating that accidents and trauma are a more frequent cause of death in patients with epilepsy than in the general population. There is also an increased mortality from drowning among people with epilepsy. Mortality rates also indicate that patients with epilepsy are at a higher risk of committing suicide.

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  • Category: Nervous diseases