[Possibilities for recovery in epilepsy]

Using information from a database of 5,000 cases of epilepsy, the author studies the clinical evolution of 3,601 patients who had been followed over a period between 1 and 40 years (mean follow-up period, 10 years). According to the results obtained with anticonvulsant drugs, controllable forms of epilepsy were those in which at least 1 years had transpired without seizures occurring. This accounted for 74.7% of the cases. Of the remaining 25.3%, 4.3% presented occasional seizures and 21% presented seizures that did not respond to medication, in particular 515 cases that could be considered severe or untreatable forms of epilepsy. Anticonvulsant medication was discontinued in 760 epileptics. Only 20% of these patients had relapses after a mean follow-up period of approximately 5 years. Risk factor determining the control of seizures or the possibility of successful drug withdrawal were as follows: time lapse before diagnosis, concurrence of different types of seizures in the same patient, presence of status, permanent neurological deficits as well as mental disorders. Permanent neurologic deficits would seem to be of greater importance than mental disorders in determining drug withdrawal.