The long-term prognosis of newly diagnosed epilepsy in Egypt: A retrospective cohort study from an epilepsy center in Greater Cairo

Ayman Ashmawi, Hassan Hosny, Ahmed Abdelalim, Elisa Bianchi, Ettore Beghi

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose To investigate the long-term prognosis and prognostic patterns of epilepsy in a single practice study from a developing country. Methods Consecutive patients first seen in an epilepsy clinic in Cairo, Egypt between January 1994 and December 2009 with at least 4 years of follow-up were included. Demographic, clinical, EEG and imaging findings at diagnosis were recorded. At follow-up, treatment was adjusted as clinically indicated. The response to the first drug was defined as 6-month seizure remission. Outcome measures included 2-year remission (R) and 2-year sustained remission (SR). Prognostic patterns were early (ER) and late remission (LR), relapsing-remitting (RR) course, worsening course (WC) and no remission. Results Included were 287 patients aged 1–66 years and followed for 2237.0 person-years (mean 7.8 years). 244 (85%) attained 2-year R. The cumulative time dependent probability of R was 86.7% at 10 years. Only the response to the first drug predicted R. 82 (28.6%) attained 2-year SR. The probability of SR was 40.9% at 10 years. Poor treatment response and nocturnal seizures predicted lowered SR. R and SR were inversely correlated to the number of drugs. 208 patients (72.5%) entered ER, 36 (12.5%) entered LR, 138 (48.1%) had RR course. A WC was present in 24 (8.4%), 43 (15.0%) never entered remission. Prognostic patterns varied with neurological examination, MRI findings, pre-treatment seizure frequency, seizure type, number of seizure types, etiology, syndrome and response to first drug. Conclusions The long-term prognosis of newly diagnosed epilepsy patients from a developing country is in keeping with published reports.

Original languageEnglish
Pages (from-to)86-95
Number of pages10
JournalSeizure
Volume41
DOIs
Publication statusPublished - Oct 1 2016

Keywords

  • Drug treatment
  • Newly diagnosed epilepsy
  • Prognosis
  • Prognostic predictors
  • Relapse
  • Remission

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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