International Journal of General Medicine (Apr 2021)
A Scale for Predicting the Outcomes of Patients with Epilepsy: A Study of 141 Cases
Abstract
Xu Chen,1,2 Xiao-Bo Ma,3 Qiang Zhang,3 Qing Yin,1 Xiao-Hong Li1 1Department of Neurology, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China; 2Department of Neurology, ShuLan (Hangzhou) Hospital, Hangzhou, People’s Republic of China; 3Department of Neurology, Jen Ching Memorial Hospital, Kunshan, People’s Republic of ChinaCorrespondence: Xiao-Hong LiDepartment of Neurology, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, No. 105 of Jiefang Street, Lixia District, Jinan, People’s Republic of ChinaTel +86 035155863234Fax +86 035155863234Email [email protected]: This study aimed to identify the factors relevant for developing a scale to estimate the prognosis of patients with epilepsy.Methods: This study followed 141 patients with newly or previously diagnosed epilepsy for between four and nine years. The patients were divided into three groups on the basis of their outcomes during the follow-up period: patients that were seizure-free without anti-epileptic drugs (AEDs) (group A, n = 48), patients with pharmacoresponsive epilepsy (group B, n = 52), and patients with pharmacoresistant epilepsy (group C, n = 41). The predictors of the prognosis of epilepsy were determined using logistic regression models and optimum subsets regression, and a scale for estimating the prognosis of epilepsy (SEPE) was developed.Results: The SEPE was able to distinguish between better and worse outcomes for the three groups. A score ≤ 3 on the SEPE predicted that a patient would become seizure-free without the use of AEDs, with a specificity of 67% and a sensitivity of 50%. A score ≤ 4 on the SEPE predicted that a patient may have a positive outcome; scores in this range were assigned to 97.9% of patients that were seizure-free without the use of AEDs and 65% of patients with pharmacoresponsive epilepsy, with a specificity of 80%, a sensitivity of 81%. Scores ≥ 6 on the SEPE predicted a poor outcome.Conclusion: Of the patients with a SEPE score ≤ 3, some were able to become seizure-free without the use of AEDs, while for other patients, it may be possible that AED use can be discontinued. Patients with a SEPE score ≤ 4 have the potential to achieve long-term remission. Patients with a SEPE score ≥ 6 are more likely to have pharmacoresistant epilepsy.Keywords: epilepsy, prognosis, factors, score
