Neurobiological and clinical predictors of remission and antiepileptic treatment efficacy in partial epilepsies

Abstract

The current knowledge of significance of some neurobiological and clinical variables in the prediction of remission length and seizures reduction in partial epilepsies remains sparse and even controversial.

The current study has been carried out in order to evaluate the possible relationship between epilepsy forms, gender, focus lateralization and handedness with therapeutic remission and seizures reduction during antiepileptic treatment in persons with partial forms of epilepsy.

One hundred and eight patients were studied. Handedness was evaluated using the Annett’s scale. Focus lateralization was detected by use of the EEG. Of the patients studied temporal lobe epilepsy (TLE) was diagnosed in 61 cases and frontal lobe epilepsy (FLE) in 47 cases. There were 44 men and 64 women, of which 83 were right-handed and 25 were left-handed. A left-sided focus was detected in 59 persons whilst a right-sided focus was noted in 49 persons. MANOVA was used for the analysis of interrelationship between four nominal fixed factors (epilepsy forms, gender, handedness, and focus laterality) and dependent variables of therapeutic remission and percentage seizures reduction.

A favorable prognostic significance of FLE vs TLE was observed. In contrast gender, handedness, and focus laterality had no influence on the dependent variables when analyzed separately. However, when two, three and four independent variables were combined an influence on the dependent variables was observed; and some combinations may be used for prediction purposes of therapeutic remission and percentage in seizure reduction. The FLE in the men with the right-handedness and the left focus (FLE·M·Rh·LF) resulted in the maximal length of therapeutic remission and maximal seizures reduction, while the other combinations have resulted in less favorable treatment results. The TLE·M·Rh·RF and TLE·M·Lh·LF were the worst combinations for the remission length and TLE · Fe · Lh · LF for the seizures reduction.

The current study revealed the significance of combinations of some neurobiological and clinical variables in prediction of therapeutic remission and percent of seizures reduction irrespective of used antiepileptic drugs. These results may be used so as to aid patient selection before drug treatment in order to form the homogenous groups of persons.