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Good Seizure Control Now May Turn Bad

Some Patients Symptom-Free for Years, Only to Have Worse Seizures Later
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WebMD Health News

Jan. 28, 2003 -- Unfortunately, how well epileptic seizures are controlled today doesn't predict how well they will be controlled in the future, a new study shows.

It's generally believed that getting seizures under control with medication is a good indicator of long-term success. In fact, current guidelines advise stopping seizure drugs once a patient has been seizure-free for two years.

"And if they come off medication and remain seizure-free for three years, we tend to think they are home free," says epilepsy researcher Anne T. Berg, PhD, of Northern Illinois University. "That's because it is generally assumed -- perhaps without much evidence -- that if you do well early on, you will continue to do well."

However, she reports in the Jan. 28 issue of Neurology that some patients may go seizure-free for years or decades -- only to have their epilepsy come back with a vengeance.

The researchers studied 333 adults with epilepsy severe enough to need surgery. They found that, on average, nine years passed between diagnosis and brain surgery to control their seizures. One in four study participants even went a full year without a seizure before requiring surgery.

Berg tells WebMD that she doesn't know what causes the medications to stop working. "But the phenomenon we're seeing is that some patients start off as children doing quite well, going years of being seizure-free. And then their epilepsy comes back in a more severe form when they are adults."

The next step, she says, is to figure out which patients' epilepsy can't be controlled and might require very aggressive treatment like surgery.

An early clue: "Our finding suggests that this primarily occurs in people who first had seizures in early childhood."

About 2% of the world's population has epilepsy. About 125,000 new cases are diagnosed each year -- one-third of them in children, reports the Epilepsy Foundation.

Have more questions about epilepsy? See our series of articles about everything from when to call your doctor to health tools for controlling epilepsy.

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