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the Department of Veterans Affairs Epilepsy Cooperative Studies No. 118 and No. 264 Group*; *Participants in the Epilepsy Cooperative Studies No. 118 and No. 264 are listed in Appendix 1 *Table 3*.
From the Neurology Service (Dr. Mattson and J. Cramer), Department of Veterans Affairs Medical Center, West Haven, CT; the Department of Neurology (Dr. Mattson and J. Cramer), Yale University School of Medicine, New Haven, CT; and the Cooperative Studies Program Coordinating Center (Dr. Collins), Department of Veterans Affairs Medical Center, Perry Point, MD.
Supported by the Department of Veterans Affairs Medical Research Service, Cooperative Studies Program (CSP No. 264).
Received May 25, 1995. Accepted in final form December 4, 1995.
Address correspondence and reprint requests to Dr. Richard Mattson, Neurology-127, VA Medical Center, 950 Campbell Ave., West Haven, CT 06516.
Background: Two prospective observations of adults with symptomatic, localization-related (partial) epilepsy included 1,102 patients in VA multicenter studies (VA-118 and VA-264). Analyses assessed the likelihood of remaining seizure free for 12 and 24 months after initiating adequate antiepileptic drug therapy. Methods: Patients were grouped as having only secondarily generalized tonic-clonic seizures (GTC), only complex partial seizures (CPS), or both types (MIXED) at entry. The cumulative proportion of patients remaining seizure free with standard antiepileptic drug therapy was determined by actuarial life table methods. Results: At 12 months, 70% and 61% of GTC patients (VA-118 and VA-264, respectively) had no further GTC; 53% and 50% of MIXED, predominantly GTC patients had no further GTC, 21% and 28% of CPS patients had no further CPS and 98% and 91% were seizure free for GTC; 32% and 35% of MIXED, predominantly CPS patients had no further CPS, and 62% and 51% of patients with MIXED seizure types remained seizure free for CPS for 12 months after enrollment. Conclusions: The overall prognosis for control of seizures of any type for 12 months was best for those who had only GTC at entry (55% and 48%), worst for those who had only CPS at entry (23% and 26%), and intermediate for those with MIXED seizures at entry (32% and 25%) (all p < 0.0001). Prognosis can be based on the predominant seizure type in patients with multiple types.
NEUROLOGY 1996;47: 68-76
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