For patients with epilepsy, response to first drug treatment maysignal likelihood of future seizure
How well people with newly diagnosed epilepsy respond to their first drug treatment, may signal the likelihoodthat they will continue to have uncontrolled seizures according toUniversity of Melbourne Chair of Neurology Professor Patrick Kwan. In a study published in Neurology , the medical journal of the American Academy of Neurology,Professor Kwan, who is also head of the clinical epilepsy programat the Royal Melbourne Hospital and an international authority inantiepileptic drug development, believes a pattern emerges in theearly stages. “Our research shows a pattern based on how a person responds toinitial treatment and specifically, to their first two courses ofdrug treatment,” said Dr Kwan. For the study, 1,098 people from Scotland between the ages of nineand 93 with newly diagnosed epilepsy were followed for as long as26 years after being given their first drug therapy. Participantswere considered seizure-free if they had no seizures for at least ayear without changes in their treatment.
If they had furtherseizures, a second drug was chosen to be given alone or to be addedto the first. If seizures continued, a third drug regimen wasselected, and the process continued for up to nine drug regimens. The study found that 50 percent of the people were seizure-freeafter the first drug tried, 13 percent were seizure-free after thesecond drug regiment tried and 4 percent were seizure-free afterthe third. Less than two percent of the participants stopped havingseizures on additional drug treatment courses up to the seventh onetried, and none became seizure-free after that. The research also found that 37 percent of people in the studybecame seizure-free within six months of treatment. t.
Another 22percent became seizure-free after more than six months of startingtreatment. Both groups continued to be seizure-free. However, 16percent had fluctuating periods of seizure freedom and relapses,and 25 percent were never seizure-free for one year. At the end of the study, 749 people (68 percent) were seizure-freeand 678 people (62 percent) were on only one drug. The results wereindependent of the age when the person had the first seizure or thetype of epilepsy.
“A person who doesn’t respond well to two courses of epilepsy drugtreatment should be further evaluated to verify an epilepsydiagnosis and to identify whether surgery or other treatmentmodalities is the best next step,” said Professor Kwan. “Whilefreedom from seizures is the goal of treatment, we still have toconsider quality of life issues for each individual patient.” Affecting 50 million people worldwide, epilepsy is the most commonserious neurological disorder and a major global public healthissue. Identifying drug resistance promptly and understanding thegenetic risk factors predisposing to epilepsy and drug resistancecan help doctors find better treatment and potentially preventivetherapy. Additional References Citations.
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