Question
The patient began taking epilepsy medication at the end of last year and has not had a recurrence since then. Before the past seizures, there were symptoms of warning, and occasional pre-seizure symptoms occurred during medication, mostly during naps, but no actual recurrence has occurred. What could be the reason for this?
Answer
Epilepsy is a chronic disease that, if not well controlled, can last for years or even decades, affecting the patient’s physical and mental health, marriage, economic status, social position, and family. However, the prognosis for most epilepsy patients is good, with only a small number being difficult to control and having poor outcomes. According to surveys, about one-third of patients can self-resolve without treatment due to few recurrences and mild symptoms. For those who require treatment, if they can appropriately and sufficiently utilize anti-epileptic therapy, 60% to 80% can achieve good results. A British study shows that about 75% of patients can be cured or have long-term non-recurrence under effective medication control, with one-third of patients experiencing more than 2 years of remission. Poor prognostic conditions include: recurrence before 1 year old, infantile spasms, psychomotor recurrence or mixed type recurrence, abnormal EEG or progressive deterioration, frequent recurrence, persistent epilepsy status recurrence after discontinuation of medication, long course of illness, and recurrence after discontinuation of medication. If these conditions can be removed by eliminating relevant causes and receiving appropriate and sufficient treatment while maintaining long-term persistence, there is also hope for some to be cured. In summary, epilepsy patients should maintain an optimistic attitude, build confidence in overcoming the disease, persist in long-term treatment, discontinue medication after 2 years of remission, and as long as they can control non-recurrence, they can work, live, and study normally and contribute to society like others.