Lamberink et al reported a nomogram for predicting risk of seizure recurrence followiing discontinuation of antiepileptic drug therapy.
Parameters:
(1) age at onset of seizures, from 0 to 80
(2) epilepsy duration before remission, in years, from 0 to 40
(3) seizure-free interval before antiepileptic drug withdrawal, from 0 to 24
(4) history of febrile seizures
(5) number of seizures before remission
(6) self-limited seizure syndrome
(7) developmental delay
(8) EEG before antiepileptic drug withdrawn
|
Age in Years |
Points |
|
0 to 3 |
(0.125 * ((years)^2)) - (1.225 * (years)) + 2.525 |
|
3-4 |
0 |
|
4 to 10 |
(-0.032334 * ((years)^3)) + (0.64185 * ((years)^2)) - (2.8935 * (years)) + 3.3535 |
|
10 to 80 |
(0.090617 * (years)) + 3.8834 |
Epilepsy duration
|
Epilepsy Duration |
Points |
|
0 to 10 |
(-0.10106 * ((years)^2)) + (1.8328 * (years)) + 0.10187 |
|
10 to 40 |
(0.068027 * (years)) + 7.7929 |
Seizure free interval
|
Interval in Years |
Points |
|
0 to 2 |
20 |
|
3 to 5 |
(-0.084656 * ((years)^2)) - (0.12698 * (years)) + 20.72 |
|
5 to 24 |
(-0.945 * (years)) + 22.677 |
|
Parameter |
Finding |
Points |
|
history of febrile seizures |
negative |
0 |
|
|
positive |
3.3 |
|
number of seizures before remission |
< 10 |
0 |
|
|
>= 10 |
3.1 |
|
self-limited seizure syndrome |
yes |
0 |
|
|
no |
5.6 |
|
developmental delay |
no |
0 |
|
|
yes |
2 |
|
EEG before drug withdrawal |
normal or not performed |
0 |
|
|
epileptiform abnormality |
4 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 59.6
• The higher the score the greater the risk of recurrence.
|
Score |
2-year risk of recurrence |
|
<16.3 |
< 10% |
|
16.3 to 47.7 |
(0.000438 * ((score)^2)) - (0.00131 * (score)) - 0.007755 |
|
> 47.7 |
> 90% |
|
Score |
5-year risk of recurrence |
|
< 12.9 |
< 10% |
|
12.9 to 44.4 |
(0.000437 * ((score)^2)) + (0.0017 * (score)) - 0.00817 |
|
> 44.4 |
> 90% |
Specialty: Pharmacology, clinical, Neurology
