Predictors of seizure outcome in newly diagnosed partial epilepsy: memory performance as a prognostic factor

The epilepsy patients whose seizures will prove to be refractory should be identified as early as possible, and thus the need for new prognostic facto rs of intractable epilepsy is evident. The aim of the study was to investig ate predictors of seizure outcome in a multivariate analysis. Neurological, electroencephalography (EEG) and neuropsychological variables were analyze d as potential predictors of epilepsy. Eighty-nine newly diagnosed adult pa tients with partial epilepsy were, after a prospective 2-year follow-up per iod, categorized into one of the two groups: patients with satisfactorily c ontrolled epilepsy, and patients with refractory epilepsy. Six variables pr edicted 2-year seizure outcome: presence of spike focus in EEG, partial com plex or mixed seizure type, remote symptomatic etiology, moderately impaire d memory performance in immediate recall and in delayed recognition of the word list, and age at the time of diagnosis. The correct seizure outcome co uld be predicted with the model in 94% of newly diagnosed epilepsy patients . The presence of verbal memory impairment at the time of the diagnosis of partial epilepsy is a significant predictor of seizure outcome and, togethe r with clinical and EEG variables, it predicts seizure outcome in the major ity of the patients. Memory performance as a prognostic factor is of most v alue in patients with risk of refractory epilepsy and when used in a multid isciplinary setting. (C) 1999 Elsevier Science B.V. All rights reserved.