Patient's question:
I started taking epilepsy medication at the end of last December, and so far, I haven't had a recurrence once. In the past, I always had warning signs before an episode. During the time I've been on medication, I've experienced symptoms of these pre-episode warnings two or three times a month, mostly during my midday naps, but I've never had a recurrence. What could be the reason for this? Could you please answer in text?Doctor's answer:
Epilepsy is a chronic disease. If not well-controlled, it can last for several years or even decades, affecting the patient's physical health, mental well-being, marriage, finances, social status, and family. As a result, many epilepsy patients hold a pessimistic attitude about whether the disease can be cured. It must be pointed out that the prognosis for most epilepsy cases is relatively good. Of course, there are also a few cases that are difficult to control and have an unsatisfactory prognosis.According to surveys, about one-third of epilepsy patients experience only a few relapses, which are relatively mild, and they may spontaneously remit without any treatment. Those who do require treatment can achieve excellent results if they are appropriately and sufficiently treated with antiepileptic drugs, with 60% to 80% of them experiencing significant improvement. In the UK, systematic research on the prognosis of epilepsy patients showed that approximately 75% of patients can be cured or remain free from recurrence for a long period with effective drug control. Over one-third of patients can achieve relief for more than two years. Primary epilepsy patients who have fewer than two recurrences per year and whose EEGs are normal or show gradual improvement also have a good prognosis.
Poor prognoses are associated with: onset before the age of one, infantile spasms, psychomotor seizures or mixed seizures, abnormal EEGs or progressive deterioration, frequent relapses, seizures during status epilepticus, long disease duration, and relapse after medication withdrawal. Analyzing these various conditions, as long as the underlying causes are addressed and appropriate and sufficient treatment is administered with long-term adherence, some cases can be corrected, and there is hope for recovery.
In summary, epilepsy patients should maintain an optimistic attitude, build confidence in overcoming the disease, and persist in long-term treatment. Medication should only be discontinued after a prolonged period of remission (at least two years), as long as the disease remains under control and does not recur. Patients can continue to work, study, and live normally while undergoing treatment, making contributions to society that are equal to those of healthy individuals.