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

Ashmawi, Ayman et al.

Seizure: the journal of the British Epilepsy Association. Volume 41 (2016); pp 86-95 -- Elsevier Ltd

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  • Title:
    The long-term prognosis of newly diagnosed epilepsy in Egypt: A retrospective cohort study from an epilepsy center in Greater Cairo
  • Author: Ashmawi, Ayman;
    Hosny, Hassan;
    Abdelalim, Ahmed;
    Bianchi, Elisa;
    Beghi, Ettore
  • Found In: Seizure: the journal of the British Epilepsy Association. Volume 41 (2016); pp 86-95
  • Journal Title: Seizure: the journal of the British Epilepsy Association
  • Subjects: Épilepsie--Périodiques; Seizures--Periodicals; Electronic journals; Epilepsy--Periodicals; Prognosis--Newly diagnosed epilepsy--Drug treatment--Remission--Prognostic predictors--Relapse; Dewey: 616.853
  • Rights: legaldeposit
  • Publication Details: Elsevier Ltd
  • Abstract: Highlights:

    Prognosis of Egyptian newly diagnosed patients was keeping with published reports.

    First drug response was the only independent predictor of 2-year remission and SR.

    Nocturnal seizures were an independent predictor of sustained remission.

    Prognostic patterns varied according to the clinical variables at time of diagnosis

    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.


  • Identifier: System Number: LDEAvdc_100070312234.0x000001; Journal ISSN: 1059-1311; 10.1016/j.seizure.2016.07.016
  • Publication Date: 2016
  • Physical Description: Electronic
  • Shelfmark(s): ELD Digital store

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