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))
Specialty: Pharmacology, clinical, Neurology