Prognosis of seizures in medically-treated adolescent and adult Nigerian epileptics.

One hundred and four unselected adolescent and adult epileptics treated in Lagos University Teaching Hospital were followed up for 3 years to determine their seizure prognosis. We found 37% completely free of seizures; marked improvement in 30%, moderate improvement in 11%, slight improvement in 10% and no improvement in seizure control in 13% of the patients. The study also indicated that prognosis of seizure control is more favourable: (a) in generalised than in partial epilepsy; (b) in patients with onset of seizures after the age of 10 years and in particular after the age of 30 years; (c) in patients with less frequent seizures; (d) in patients who started treatment within 2 years of onset of seizures; (e) in patients who had initially a normal EEG. The prognosis of seizure control was less favourable in patients who were treated with native herbs by traditional healers prior to hospital treatment probably because the majority of them started medical treatment later than 2 years after the onset of seizures. There was no relationship between seizure prognosis and the number of anti-epileptic drugs taken by the patients. Most of the patients (79%) claimed they took drugs regularly although there were no serum levels to confirm these claims. There was no relationship between seizure prognosis and drug compliance as claimed by the patients.