[A study on the prediction of long-term prognosis of adulthood epilepsy]

We report results of a study on the relation between the clinical findings 2 years after initiation of the therapy and the long-term prognosis of seizure control, and discuss the possibility of predicting the prognosis in the early stage of therapy. The subjects consisted of 141 patients, observed for 10 to 20 years at Hirosaki University Hospital. Regarding the epilepsy type, the prognosis of temporal lobe epilepsy was unfavorable. In temporal lobe epilepsy, only 21% were in remission (seizure-free for 3 years or more) at the time of the study. Also, the presence of organic brain lesions or neuropsychiatric complications at the early stage of treatment was associated with unfavorable prognosis. We are particularly interested in the possibility of predicting the long-term prognosis from the result of early response to anti-epileptic drug therapy. We found a significant correlation between the early excellent response to drug treatment and the good long-term prognosis. Using discriminant analysis (quantification theory II), we tried to find which factors would influence more to the long-term prognosis. As the result, an importance was found in the following order: (1) epilepsy type, (2) presence or absence of neuropsychiatric complications, (3) age at onset, (4) early response to treatment, (5) presence or absence of organic brain lesions and (6) the interval between the onset and the initiation of drug treatment. Correct identification rate by discriminant analysis was 73%.