DOES EARLY TREATMENT FOR SINGLE SEIZURES AND EARLY EPILESPY ALTER LONG PROGNOSIS? RESULTS FROM THE MULTICENTRE STUDY OF EARLY EPILEPSY AND SINGLE SEIZURES ON BEHALF OF THE MESS STUDY GROUP
Abstract number :
3.146A
Submission category :
Year :
2002
Submission ID :
332
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Anthony G. Marson, David W. Chadwick, Ann Jacoby, Anthony L. Johnson. Department of Neurological Science, University of Liverpool, Liverpool, United Kingdom; Department of Primary Care, University of Liverpool, Liverpool, United Kingdom; MRC Biostatistics
RATIONALE: At the end of this activity the participants should undestand the effect of early treatment for single seizures and early epilepsy upon longer term prognosis. The fact that antiepileptic drugs reduce the likelihood of seizures for people with epilepsy is undisputed. Whether they influence the natural history of the condition (epileptogenesis) is uncertain. We report the largest completed epilepsy randomized controlled trial. In this trial antiepileptogenic effects were investigated for people with single seizures and early epilepsy.
METHODS: We undertook a pragmatic unblinded multicentre randomized controlled trial. We recruited people (adults or children) following a single seizure or with early epilepsy for whom both clinician and patient were uncertain as to whether antiepileptic drug treatment was required. Participants were randomized to either a policy of delayed treatment or a policy of immediate treatment. For those allocated immediate treatment, the choice of treatment was made by the treating clinician. For those allocated to delayed treatment, where necessary, treatment could be initiated at any time post randomization. Outcomes were time to first seizure post randomization and time to 24 month remission. Recruitment started in 1993 and ended in December 2000 and participants were followed up to the end of 2001.
RESULTS: 1443 participants were randomized, 833 following a single seizure and 610 following two or more seizures. 722 were allocated immediate and 721 to delayed treatment. The median follow up was 4.3 years. 717 were from the UK, 624 from other European companies, 34 from India and 68 from South America. The age of participants ranged from 5 months to 92 years, mean 30 years. 826 (62%) were male. Results for time to first seizure and 24 month remission will be presented.
CONCLUSIONS: The influence of results upon future treatment policies will be outlined.
[Supported by: Medical Research Council UK]