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  1. If a first antiepileptic drug fails to control a child's epilepsy, what are the chances of success with the next drug ?

    Article - En anglais


    This study was carried out to determine how often a child's epilepsy is controlled and remits if a first antiepileptic drug (AED) fails to control seizures.

    Study design 

    We used the Nova Scotia population-based epilepsy study, which identified children between 1977 and 1985 who had two or more unprovoked seizures without progressive cause and followed them up for at least 4 years.

    Seizure types were partial, primary, and secondarily generalized (excluding absence seizures).

    The study documented success or failure of the initial AED in the first year of treatment, as well as long-term seizure control and remission.


    The number of eligible children was 417, with an average follow-up period of 8 years.

    The initial prescribed AEDs were phenobarbital (48%), carbamazepine (38%), and phenytoin (11%). Overall, 345 (83%) children received only one AED in the first year of treatment ; 61% became free of seizures and no longer required AED treatment at the end of follow-up (remission).

    Only 4% of those treated with a single AED during the firstyear later experienced intractable epilepsy.

    In contrast, 72 of 417 (17%) had inadequate seizure control with their first AED and received a second AED, with only 42% having complete remission of their epilepsy.

    The 72 children in whom seizures were not controlled with the first AED were more likely to have neurologic deficits (p=0.01) and complex partial seizures (p=0.01), and 29% had intractable epilepsy (p<0.0001). (...)

    Mots-clés Pascal : Epilepsie, Enfant, Homme, Traitement, Anticonvulsivant, Chimiothérapie, Modalité traitement, Epidémiologie, Efficacité traitement, Pronostic, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Antiépileptique

    Mots-clés Pascal anglais : Epilepsy, Child, Human, Treatment, Anticonvulsant, Chemotherapy, Application method, Epidemiology, Treatment efficiency, Prognosis, Nervous system diseases, Central nervous system disease, Cerebral disorder

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0090815

    Code Inist : 002B02B06. Création : 14/05/1998.