RATE OF FREEDOM FROM SEIZURE MAY BE HIGHER THAN EXPECTED IN PATIENTS WITH EPILEPSY. Patients with established epilepsy may have a 48% chance of becoming seizure-free, according to research by Nathan B. Fountain, MD, associate professor of neurology, and colleagues at the University of Virginia (UVA), Charlottesville. Although the rate of freedom from seizure is unknown except for in a few specific epilepsy syndromes, the authors hypothesized that the rate may be higher than expected.
The researchers prospectively collected data from established and new patients with definite epilepsy who were older than 5 years and seen in the UVA Epilepsy Clinic.
Freedom from seizure was defined as no seizures for at least 6 months in patients who previously had had 3 or more seizures. Baseline seizure frequency for these patients was as follows: 15% had more than 15 per month, 56% had 1 to 15 per month, and 21% had fewer than 1 per month.
Of these 988 patients, 243 (25%) were seizure-free by the end of the study; an additional 231 (23%) had previously achieved freedom from seizures, and 514 (52%) continued to experience seizures. Among those patients who became seizure-free, mean follow-up time was 24.5 months and mean duration of freedom from seizure was 20.9 months.
Patients with generalized seizures or idiopathic generalized and idiopathic localization-related epilepsy were more likely to become seizure-free. The researchers noted, however, that some seizure freedom can occur in any patient regardless of seizure type.
GLUCOSE METABOLISM MAY EFFECT DURATION OF TEMPORAL LOBE EPILEPSY. Asymmetry of glucose metabolism in the temporal lobes of persons with temporal lobe epilepsy (TLE) may be associated with the duration of epilepsy, according to research presented by Cigdem I. Akman, MD, assistant professor in clinical neurology and pediatrics at Columbia University in New York City. Akman and colleagues used 2-deoxy-2- [18F]fluoro-D-glucose positron emission tomography (18FDG/PET) to assess interictal functioning in TLE.
Fifty patients with pharmacologically resistant TLE received 18FDG/PET as part of a presurgical evaluation. Twenty-six patients had right TLE and 24 had left TLE. The mean patient age at the time of PET scan was 37 years in both groups, and the duration of epilepsy, age at onset, number of medications, and level of education were similar for both groups.