To Treat or Not to Treat…Is It Still the Question?

Abstract

Leone MA, Solari A, Beghi E; FIRST Group. Neurology 2006; 67(12):2227-2229. We followed 419 patients with a first, unprovoked, primarily or secondarily generalized tonic-clonic seizure, randomized to immediate antiepileptic treatment or to treatment only in the event of seizure recurrence. The probability of achieving a 2-year remission was 72 versus 57% at 3 months, 84 to 79% at 3 years, and 85 to 86% at 10 years (p= NS). The probability of entering 5-year remission was 47 to 40%, 58 to 58%, and 64 to 64% (p= NS). Early treatment does not affect the long-term prognosis of epilepsy