Description

The British Medical Research Council reported a prognostic index for predicting seizure recurrence in a patient with an apparent remission. The authors are from the MRC Antiepileptic Drug Withdrawal Study Group.


Patient selection: history of seizures with apparent remission, on antiepileptic therapy

 

Parameters:

(1) age in years

(2) number of antiepileptic drugs being taken

(3) seizures occurred after start of antiepileptic drug therapy

(4) history of primary or secondary generalized tonic-clonic seizures

(5) history of myoclonic seizures

(6) EEG in past year

(7) number of years free of seizures

 

Parameter

Finding

Points

age

< 16 years of age

0

 

>= 16 years of age

45

number of AE drugs

1

0

 

>= 2

50

seizures after start AED

no

0

 

yes

35

history of generalized tonic-clonic seizures

no

0

 

yes

35

history of myoclonic seizures

no

0

 

yes

50

EEG

negative

0

 

not available

15

 

abnormal

20

number of years seizure free

 

200 / (number of years)

 

subscore =

= SUM(points for all 7 parameters)

 

final score =

= (subscore) - 175

 

Interpretation:

maximum score: around 260

 

Z = EXP((score) / 100)

 

probability of seizure recurrence with continued therapy within 1 year =

= 1 - (0.89 ^(Z))

 

probability of seizure recurrence with continued therapy within 2 years =

= 1 - (0.79 ^(Z))

 

probability of seizure recurrence with slow withdrawal of therapy within 1 year =

= 1 - (0.69 ^(Z))

 

probability of seizure recurrence with slow withdrawal of therapy within 1 years =

= 1 - (0.60 ^(Z))


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