Late-life terminal seizure freedom in drug-resistant epilepsy: "Burned-out epilepsy".

Details

Serval ID
serval:BIB_0D9781A0F047
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Late-life terminal seizure freedom in drug-resistant epilepsy: "Burned-out epilepsy".
Journal
Journal of the neurological sciences
Author(s)
Rajakulendran S., Belluzzo M., Novy J., Sisodiya S.M., Koepp M.J., Duncan J.S., Sander J.W.
ISSN
1878-5883 (Electronic)
ISSN-L
0022-510X
Publication state
Published
Issued date
15/12/2021
Peer-reviewed
Oui
Volume
431
Pages
120043
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The course of established epilepsy in late life is not fully known. One key question is whether the resolution of an epileptic diathesis is a natural outcome in some people with long-standing epilepsy. We investigated this with a view to generating a hypothesis. We retrospectively explored whether terminal seizure-freedom occurs in older people with previous drug-resistant epilepsy at the Chalfont Centre for Epilepsy over twenty years. Of the 226 people followed for a median period of 52 years, 39 (17%) achieved late-life terminal seizure-freedom of at least two years before death, which occurred at a median age of 68 years with a median duration of 7 years. Multivariate analysis suggests that a high initial seizure frequency was a negative predictor (p < 0.0005). Our findings indicate that the 'natural' course of long-standing epilepsy in some people is one of terminal seizure freedom. We also consider the concept of "remission" in epilepsy, its definition challenges, and the evolving terminology used to describe the state of seizure freedom. The intersection of ageing and seizure freedom is an essential avenue of future investigation, especially in light of current demographic trends. Gaining mechanistic insights into this phenomenon may help broaden our understanding of the neurobiology of epilepsy and potentially provide targets for therapeutic intervention.
Keywords
Aged, Anticonvulsants/therapeutic use, Epilepsy/drug therapy, Freedom, Humans, Pharmaceutical Preparations, Retrospective Studies, Seizures/drug therapy, Treatment Outcome, Ageing, Pharmaco-resistance, Prognosis, Seizure outcome
Pubmed
Web of science
Create date
15/11/2021 15:44
Last modification date
06/02/2024 8:18
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