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The prognosis for people with epilepsy can vary widely depending on factors such as type of seizures, age of onset, and response to treatment. A prognosis describes how an illness or condition is likely to develop over time and/or with treatment. It can also be a prediction about how it will affect a person's life.
Epilepsy is a neurological condition characterized by recurrent seizures (temporary interruptions in electrical brain functions). Epilepsy can occur at any age, affecting around 50 million people globally.
Generally speaking, up to 70% of people who are receiving proper treatment can live seizure-free. Some people who experience seizures related to epilepsy experience no long-term adverse effects, while others can have lasting effects.
This article will discuss what influences the prognosis for people with epilepsy, its possible complications, and what treatments are available.
A number of factors influence the prognosis for epilepsy, including:
Rates of epilepsy are higher in low- to middle-income countries than in high-income countries. Almost 80% of people with epilepsy live in low- and middle-income countries.
This higher rate is thought to be due to factors such as increased risk of endemic conditions (like malaria), higher risk of injury (such as from traffic accidents), more birth-related injuries, and reduced access to medical care. Approximately 75% of people living with epilepsy in low-income countries do not receive adequate treatment for their needs.
About 70% of people newly diagnosed with epilepsy can expect to experience prolonged periods of time being seizure-free, typically as a result of medication. Approximately 50% to 75% of people whose seizures have been controlled with medication can eventually be weaned off of it. In both adults and children, remission rates tend to increase the longer the follow-up period.
A 2021 study of untreated epilepsy, primarily based in developing countries, found that approximately 30% to 40% obtain between five- and 10-year remission without treatment.
Some researchers have proposed that epilepsy prognosis be classified into four groups, as follows:
Epilepsy is usually treated with medication.
In some cases, particularly if medication is not effective, other treatments may be needed, including:
Seizure frequency is just one way prognosis for children with epilepsy is measured. Other factors to consider include:
The long-term outcome varies by child, but some overall patterns that influence prognosis have been noted and include:
In terms of incidence, epilepsy is highest in infants up to 1 year and declines to adult levels by the end of age 10.
According to a comprehensive report, approximately 35% to 50% of children with epilepsy also experience psychiatric and/or behavioral disorders, including:
The factors that influence the prognosis of childhood onset epilepsy, such as the type of epilepsy and response to treatment, also impact adult onset epilepsy.
About 70% of people will be seizure-free for five years or more. Seizure control is more likely in people with generalized tonic-clonic seizures only, and less likely for those with a combination of seizures known as focal dyscognitive seizures and tonic-clonic seizures, and a clustering of seizures.
The rate of suicide is about 3 times higher in people with epilepsy than those in the general population.
Seek immediate help if you are in a mental health crisis by calling 911 (or your local emergency number) or contacting:
Most people with epilepsy are able to lead lives similar to those without epilepsy, but some may encounter complications.
Potential complications of epilepsy include:
People with epilepsy have a higher risk of premature death than the general population, particularly in low-income countries, where 75% of people with epilepsy do not get their needed treatment.
The increased risk of death related to epilepsy or seizures can be attributed to causes such as:
SUDEP is the sudden, unexpected death of a person with epilepsy without a clear cause. It is rare, occurring in about 1 in 3,000 people with epilepsy per year, but the risk can be as high as 1 in 300 for people who have frequent, uncontrollable seizures and take high doses of anti-seizure medications.
The exact causes of SUDEP are not known, but some researchers believe it may involve factors such as:
Most people with epilepsy will become seizure-free permanently or for prolonged periods, typically with treatment such as medication. A minority will experience seizures that recur or are not controlled with treatment.
Generally, people with epilepsy lead lives that are similar to those without epilepsy. Some people may experience complications such as status epilepticus or SUDEP.
Factors that influence the prognosis for someone with epilepsy include the type of seizures, the causes of the epilepsy, response to treatment, frequency of seizures, and co-occurring conditions.
Your individual prognosis depends on a number of factors unique to you. Talk to your healthcare provider about what to expect while living with epilepsy, and the steps you can take to have to best prognosis possible.
Is epilepsy a lifelong condition?
Some people with epilepsy will go into permanent remission, while others require lifelong treatment. Up to 80% of people with epilepsy have their seizures controlled with medication or other treatments such as surgery.
Do seizures go away on their own?
In some cases, seizures due to epilepsy go away on their own over time, but most of the time treatment such as medication is needed to control seizures.
Can seizures cause brain damage?
In some cases, seizures can cause lasting damage, depending on the type and duration of the seizure. Status epilepticus (a prolonged seizure or many seizures close together) can be life-threatening or cause brain injury.