Skip to main content
The BMJ logoLink to The BMJ
. 1988 Oct 15;297(6654):948–950. doi: 10.1136/bmj.297.6654.948

The course of untreated epilepsy.

R D Elwes 1, A L Johnson 1, E H Reynolds 1
PMCID: PMC1834662  PMID: 3142563

Abstract

As little is known about the course of untreated epilepsy the time intervals between untreated tonic clonic seizures were examined retrospectively in a series of 183 patients presenting to a neurological department having had two to five seizures. After the first seizure a second attack had occurred within one month in 56 patients, within three months in 93, and within one year in 159. The median interval between the first two seizures was 12 weeks (95% confidence interval 10 to 18 weeks), between the second and third eight weeks (four to 12 weeks), between the third and fourth four weeks (two to 20 weeks), and between the fourth and fifth three weeks (one to four weeks). When patients who had had three, four, or five untreated seizures were considered separately a similar pattern of decreasing intervals was seen. Successive intervals between seizures could be compared in 82 patients. In 48 the interval decreased, in 16 it did not change, and in 18 it increased. These results suggest that in many patients there is an accelerating disease process in the early stages of epilepsy.

Full text

PDF
948

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Annegers J. F., Hauser W. A., Elveback L. R. Remission of seizures and relapse in patients with epilepsy. Epilepsia. 1979 Dec;20(6):729–737. doi: 10.1111/j.1528-1157.1979.tb04857.x. [DOI] [PubMed] [Google Scholar]
  2. Campbell M. J., Gardner M. J. Calculating confidence intervals for some non-parametric analyses. Br Med J (Clin Res Ed) 1988 May 21;296(6634):1454–1456. doi: 10.1136/bmj.296.6634.1454. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cleland P. G., Mosquera I., Steward W. P., Foster J. B. Prognosis of isolated seizures in adult life. Br Med J (Clin Res Ed) 1981 Nov 21;283(6303):1364–1364. doi: 10.1136/bmj.283.6303.1364. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Davis C. E. The effect of regression to the mean in epidemiologic and clinical studies. Am J Epidemiol. 1976 Nov;104(5):493–498. doi: 10.1093/oxfordjournals.aje.a112321. [DOI] [PubMed] [Google Scholar]
  5. Elwes R. D., Chesterman P., Reynolds E. H. Prognosis after a first untreated tonic-clonic seizure. Lancet. 1985 Oct 5;2(8458):752–753. doi: 10.1016/s0140-6736(85)90631-2. [DOI] [PubMed] [Google Scholar]
  6. Elwes R. D., Johnson A. L., Shorvon S. D., Reynolds E. H. The prognosis for seizure control in newly diagnosed epilepsy. N Engl J Med. 1984 Oct 11;311(15):944–947. doi: 10.1056/NEJM198410113111503. [DOI] [PubMed] [Google Scholar]
  7. Goodridge D. M., Shorvon S. D. Epileptic seizures in a population of 6000. II: Treatment and prognosis. Br Med J (Clin Res Ed) 1983 Sep 3;287(6393):645–647. doi: 10.1136/bmj.287.6393.645. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hauser W. A., Anderson V. E., Loewenson R. B., McRoberts S. M. Seizure recurrence after a first unprovoked seizure. N Engl J Med. 1982 Aug 26;307(9):522–528. doi: 10.1056/NEJM198208263070903. [DOI] [PubMed] [Google Scholar]
  9. Hopkins A., Garman A., Clarke C. The first seizure in adult life. Value of clinical features, electroencephalography, and computerised tomographic scanning in prediction of seizure recurrence. Lancet. 1988 Apr 2;1(8588):721–726. doi: 10.1016/s0140-6736(88)91535-8. [DOI] [PubMed] [Google Scholar]
  10. Mattson R. H., Cramer J. A., Collins J. F., Smith D. B., Delgado-Escueta A. V., Browne T. R., Williamson P. D., Treiman D. M., McNamara J. O., McCutchen C. B. Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic-clonic seizures. N Engl J Med. 1985 Jul 18;313(3):145–151. doi: 10.1056/NEJM198507183130303. [DOI] [PubMed] [Google Scholar]
  11. Reynolds E. H. Early treatment and prognosis of epilepsy. Epilepsia. 1987 Mar-Apr;28(2):97–106. doi: 10.1111/j.1528-1157.1987.tb03633.x. [DOI] [PubMed] [Google Scholar]
  12. Reynolds E. H., Elwes R. D., Shorvon S. D. Why does epilepsy become intractable? Prevention of chronic epilepsy. Lancet. 1983 Oct 22;2(8356):952–954. doi: 10.1016/s0140-6736(83)90462-2. [DOI] [PubMed] [Google Scholar]
  13. Shorvon S. D. The temporal aspects of prognosis in epilepsy. J Neurol Neurosurg Psychiatry. 1984 Nov;47(11):1157–1165. doi: 10.1136/jnnp.47.11.1157. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES