The Pharmaceutical Journal
Vol 270 No 7236 p217
15 February 2003

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Neurology abstract (more)

Drug-resistant seizures can take years to develop

Early successful treatment and control of seizures with anti-epilepsy drugs does not necessarily indicate that seizures will continue to be controlled in the future, say American researchers (Neurology 2003;60:186).

They looked at data for 333 patients to identify factors that predict when seizures will become unmanageable with drugs. They also studied the incidence of previous seizure-free periods in this group of patients. The researchers found that patients had been diagnosed with epilepsy an average of nine years before their epilepsy became unmanageable (range 0–46 years). Unmanageable, or intractable, epilepsy was defined as a failure of two medicines to control seizures. The first drugs used were generally carbamazapine, phenytoin, phenobarbital or primidone.

"The possibility that an early positive response to treatment may not necessarily guarantee a good long-term outcome is sobering news," lead author, Dr Anne Berg, Northern Illinois University, DeKalb, said.

"But it is possible that we could learn to identify those patients who will develop intractable epilepsy in the future, identify the mechanisms involved and eventually develop treatments that might prevent some forms of epilepsy from becoming intractable."

The researchers also found that a history of seizure-free periods was common in people who went on to develop intractable seizures.