Newly treated epilepsy: a French observational study.

Aims. To assess the characteristic features of epileptic patients treated for the first time with oral anti-epileptic treatments. Patients and methods. All outpatients (adults and children), who consulted for epileptic attacks and for whom an oral anti-epileptic treatment was necessary, as a first time prescription, were enrolled consecutively in this study from April 2001 up to January 2003. Data were available from a structured questionnaire delivered to all participating neurologists. Results. Two hundred sixty neurologists included 2220 patients (1162 males, 1057 females with a mean age of 41 years (from 1 month to 96 years). Forty-one percent of these patients were referred by a general practitioner and 22 percent by emergency departments. Four hundred and thirty-seven patients (19.7 percent) had only experienced a single seizure at treatment initiation. Patients were classified according to focal epilepsy (43.9 percent of patients), generalized epilepsy (46.4 percent of patients), or non-classified epilepsy (9.7 percent of patients). Sixty-six percent of patients had a biological check-up. Ninety-three percent of patients underwent an EEG and 80.7 percent a CT scan or brain MRI. The high risk of recurrence was the main reason given by neurologists for instituting anti-epileptic treatment. The reason for initiating treatment was syndromic diagnosis in 23.7 percent of patients with multiple seizures. The most frequently prescribed drug was valproic acid (58.2 percent of patients) chosen because of its practical use and broad anti-epileptic spectrum. Conclusion. This study provides a considerable amount of epidemiological and clinical information with a special emphasis on epilepsy syndromes, diagnostic assessment and factors that influence the initiation of treatment or not.