Epilepsy Health Article

Prognosis

The prognosis of epilepsy varies widely depending on the cause, severity, and patient's age. Even individuals with a similar diagnosis may have different experiences with treatment. For example, in benign epilepsy of childhood with centrotemporal spikes (also called benign rolandic epilepsy), the prognosis is excellent with nearly all children experiencing remission by their teens. With childhood absence epilepsy, the prognosis is variable. In this case, the absence seizures become less frequent with time, but almost half of patients may eventually develop generalized tonic-clonic seizures. Overall, the seizures are responsive to an appropriate anticonvulsant. On the other hand, the seizures in Lennox-Gastaut syndrome are very difficult to control. In this case, however, the ketogenic diet can help. In seizures that begin in adulthood, one can expect that medications will control seizures in up to 60–70% of cases. However, in some of the more than 30% of medically intractable cases, epilepsy surgery can improve or even cure the problem.

Overall, most patients have a good chance of controlling seizures with the available options of treatment. The goal of treatment is complete cessation of seizures since a mere reduction in seizure frequency and/or severity may continue to limit patients'quality of life: they may not be able to drive, sustain employment, or be productive in school.

BOOKS

Browne, T. R., and G. L. Holmes. Handbook of Epilepsy, 2nd edition. Philadelphia: Lippincott Williams & Wilkins. 2000.

Devinski, O. A Guide to Understanding and Living with Epilepsy. Philadelphia: F.A. Davis Company. 1994.

Engel, J., Jr., and T. A. Pedley. Epilepsy: A Comprehensive Textbook. Philadelphia: Lippincott-Raven. 1998.

Freeman, M. J., et al. The Ketogenic Diet: A Treatment for Epilepsy, 3rd Edition. New York: Demos Medical Publishing, 2000.

Hauser, W. A., and D. Hesdorffer. Epilepsy: Frequency, Causes, and Consequences. New York: Demos Medical Publishing, 1990.

Pellock, J. M., W. E. Dodson, and B. F. D. Bourgeois. Pediatric Epilepsy Diagnosis and Therapy, 2nd Edition. New York: Demos Medical Publishing, 2001.

Santilli, N. Managing Seizure Disorders: A Handbook for Health Care Professionals. Philadelphia: Lippincott-Raven. 1996.

Schachter, S. C., and D. Schmidt. Vagus Nerve Stimulation, 2nd Edition. Oxford, England: Martin Dunitz, 2003.

Wyllie, E. The Treatment of Epilepsy: Principles and Practice, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 2001.

PERIODICALS

Kwan, P., and M. J. Brodie. "Early Identification of Refractory Epilepsy." New England Journal of Medicine no. 342 (2000): 314–319.

ORGANIZATIONS

American Epilepsy Society. 342 North Main Street, West Hartford, CT 06117-2507. 860.586.7505. <www.aesnet.org>.

Epilepsy Foundation of America. 4351 Garden City Drive, Landover, MD 20785-7223. (800) 332-1000. <www.epilepsyfoundation.org>.

International League Against Epilepsy. Avenue Marcel Thiry 204, B-1200, Brussels, Belgium. + 32 (0) 2 774 9547; Fax: + 32 (0) 2 774 9690. <www.epilepsy.org>.

Roy Sucholeiki, MD