Abstract

Background: Several studies have examined remission in individuals with epilepsy and relied on factors that may affect seizure outcome. However, the information on those patients with remote symptomatic epilepsy who are prone to present remission is quite less.

Objective: To evaluate the remission rate and relapse in adult population with remote symptomatic epilepsy.

Materials and Methods: Between 2012 and 2013, we performed a retrospective study of epilepsy patients seen in 2007 at the King Abdulaziz Hospital, Jeddah, Saudi Arabia, and followed up subsequently. To be eligible for our study, potential subjects had to meet all the following criteria of symptomatic epilepsy: adult patients 12 years and above with seizures that were the result of one or more identifiable neurological insults of the brain, people with seizure-free period of 2 years and more and followed up by stopping antiepileptic drugs (AEDs), and people with follow-up of at least 2 years after the discontinuation of AED at the first visit in 2001 in which they met the inclusion criteria.

Result: The study included 145 patients with remote symptomatic epilepsy. Among most of the patients (80.6%), the type of the seizures was generalized symptomatic epilepsy, while both the focal and generalized types were reported among 16.6% of them. Patients with number of seizures ranged between three and five were significantly less likely to present remission when compared with those with one or two seizures [crude odds ratio (OR) = 0.39; 95% confidence interval (CI) = 0.18–0.83]. Patients who reported history of status epilepticus were significantly less likely to show remission when compared with those with no history of status epilepticus (crude OR = 0.33; 95%CI = 0.13–0.83). Patients who showed abnormal magnetic resonance imaging (MRI) were 57% less likely to exhibit remission when compared with those who showed normal MRI (crude OR = 0.43; 95%CI = 0.23–0.99).

Conclusion: Among the acquired causes of symptomatic etiology, the traumatic brain injury is found to be associated with a high rate of remission and good seizure outcome when compared with mesial temporal sclerosis, central nervous system infection, and vascular causes, while the malignant tumor was associated with a high rate of relapse and drug refractory epilepsy.

Key words: Epilepsy, seizure, predictor factors, relapse, remission