“We found a 5% per year terminal remission rate in our study. One of the take home messages from our findings is that continuing to attempt to improve seizure control by changing medications is important because little by little patients can achieve remission,” said Jacqueline French, M.D., Professor of Neurology at the Hospital of the University of Pennsylvania and co-director of the epilepsy center, today at the 58th annual American Epilepsy Society (AES) conference in New Orleans.

In their study, French and colleagues evaluated 246 adult patients with well defined refractory epilepsy to determine what treatment changes or additions lead to remission. All patients participating in the study had to meet the following criteria: 1) at least one seizure per month and 2) had seizures that failed to improve with at least two antiepileptic drugs (AEDs) at the index date. French and colleagues reviewed all patient records to identify current and previous drug therapy, and therapeutic interventions that occurred over the 3-year observation period. In addition, alterations of treatment strategy including surgery, drug addition, and removal or dose change were identified within three months of onset of seizure freedom.

According to the data collected, 38 of the 246 patients (15.5%) attained six-month terminal remission in seizures. Of the 21 patients referred for surgery, 11 attained six-month terminal remission, one after subsequent drug addition. New antiepileptic drugs were added 320 times, and removed 274 times. The most frequently added drug was levetiracetam, followed by zonisamide, lamotrigine, oxcarbazepine and topiramate. “Levetiracetam was the most frequently newly prescribed add-on drug over the three-year period because it had been recently introduced to the market, and perhaps because it is a very easy drug to add-on - unlike other drugs it does not have to be as carefully titrated,” said French.

She believes this study is only one of many to come and is optimistic that further prospective studies will show an increasing rate of remission amongst adult patients with refractory seizures.

The abstract of this study is published in Epilepsia 2004, Vol. 45, Supplement 7, p.75-76.