Diagnosing XXXX : response to sequential treatment schedules.

@entity1 @entity410 @entity302
Diagnosing @entity302 would facilitate referral for specialist pharmacological review and early consideration of @entity302 surgery. An outcomes study was undertaken in an unselected cohort of newly diagnosed @entity1 to determine the number of antiepileptic drug (AED) regimens needed to be failed before the @entity302 could be designated as pharmacoresistant. Between July 1982 and May 2001, 780 adolescents and adults prescribed their first AED at the Western Infirmary in Glasgow, Scotland provided longitudinal data suitable for analysis. Overall, 504 (64.6%) @entity1 became @entity410 free for at least 12 months. Of these, 462 (59.2%) remained in remission, while 42 (5.4%) relapsed and subsequently developed @entity302 . The relapse rate peaked at 10.4% after 8 years of follow-up. The other 276 (35.4%) @entity1 were uncontrolled from the outset. Prognosis appeared better in seniors (85% remission, P < 0.001) and adolescents (65% remission, P < 0.01) than in the remainder of the population (55% remission). Overall response rates with the first, second and third treatment schedules were 50.4, 10.7 and 2.7%, respectively, with only 0.8% @entity1 responding optimally to further drug trials. @entity1 not tolerating at least one AED schedule did better than those failing because of lack of efficacy. These data suggest that suitable @entity1 failing two AED regimens should be referred for @entity302 surgery. Those who do not attain long-term @entity410 freedom with the first three treatment schedules are likely to have @entity302 .
