A Prospective Cohort Study Of Different Patterns Of Treatment Response In Newly Diagnosed Epilepsy

ObjectiveTo investigate the predictors of different outcome in newly diagnosed epilepsy.MethodsFollow up the newly diagnosed epilepsy who visited The Second Affiliated Hospital of Zhejiang University from2009.01.01to2013.06.01every three months, and record the seizure times before treatment, EEG, MRI and the seizure frequency after treatment, the compliance to treatment,et al. Devide the patients into four patterns according to the different response to AED treatment. Pattern A:Patients became seizure-free early (either immediately after or within6months of commencing treatment) and remained so throughout follow-up. Pattern B:Patients became seizure-free late (more than6months after starting treatment) but also remained seizure-free throughout follow-up. Pattern C:There’s a relapsing course with periods of seizure freedom. Pattern D:never became seizure-free for any complete year. Prognostic predictors were assessed by logistic regression analysis in SPSS20.0. Results222newly diagnosed epileptic patients were included, the mean age was22years old and every patients was followed for more than20months. At the end of follow-up,96patients reached to Pattern A(43.2%), and32patients with Pattern B(14.4%),25patients with Pattern C(11.3%),69patients with Pattern D(31.1%). Compared Pattern A with B, we can see that the patients with muitiple seizure types are more difficulty to aquire early remission(OR=4.101, P=0.011). Compared tha Pattern(A+B) with C, it shows that the patients with muitiple seizure types and poor compliance tend to experience the relapsing course(OR=2.925,3.922; P=0.043,0.012). Compared the Pattern (A+B+C) with D, the patients who experience more than5seizures before treatment and who have the muitiple seizure types less likely to acheieve seizure remission for more than1year(OR=3.073,2.587; P=0.002,0.008). Conclusion The treatment outcomes are effected by many factors. Simple seizure type may be associated with early remission. The mutiple seizure types and poor compliance may lead to the relapsing course. The kinds of seizure type and times before treatment may relate with the outcome of remission or not.