Although the majority of patients with epilepsy in childhood are free of seizures by the time they become adults, they are at increased risk for social and educational problems. Patients whose epilepsy does not remit also have an increased risk of death.

Summary: Purpose:To study the effect of childhood-onset epilepsy without other neurologic deficit on adult social adjustment and competence.Methods: Social competence was studied in a prospective, population-based cohort of childhood-onset epilepsy after a mean follow-up of 35 years. One hundred patients (60% of the total cohort) had no other neurologic problems ("epilepsy only"), and for each patient, two matched controls, a "random" control and an "employee" control were chosen.Results: Good social outcome was significantly reduced in the "epilepsy only" cohort compared with random controls: education [cumulative odds ratio (COR), 2.4; 95% confidence interval (CI), 1.4-4.11; employability (COR, 7.3; 95% CI, 2.7-20.0); and marriage rate (COR, 3.7; 95% CI, 1.9-7.3). The patients with epilepsy rated their own ability to control their lives as "poor or missing" four times more frequently than the employee controls. Patients receiving antiepileptic polytherapy, but not monotherapy, were significantly less satisfied with their present life (OR, 6.7; 95% CI, 1.9-24.1) and felt their general health was significantly poorer (OR, 5.1; 95% CI, 1.2-21.3) than did the employee controls. Furthermore, patients with continuing seizures were significantly less satisfied with their present life (OR, 4.1; 95% CI, 1.1-15.1) than were employee controls.Conclusions: Many patients with "epilepsy only" beginning in childhood have persistent and significant socialadjustment and competence problems in adulthood. Key Words: Pediatric epilepsy-Social adjustment in epilepsy-Education and employability in epilepsy-Life management in epilepsy.

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Epilepsy per se, but not AEDs, has an apparent association with the occurrence of psychiatric and psychosomatic disorders. Risk for somatic comorbidity is not increased.

Summary: Purpose: To show any possible associations between childhood-onset epilepsy and physical activity, health-related fitness, and health experience.Methods: A population-based cohort of 176 patients with epilepsy since childhood was monitored for a mean of 35 years. Patients with recurrent, unprovoked epileptic seizures with no associated initial neurologic impairment or disability, termed those with "epilepsy only" (n = loo), were compared with matched controls for self-reported physical activity, health experience, laboratory tests, body mass index, and muscle power tests.Results: On the basis of muscle tests, physical fitness proved to be significantly poorer in patients with "epilepsy only" than in matched controls. During the preceding year, 22% of patients and 24% of controls had reduced their physical activities because of some illness; only 2% reduced their physical activities because of epilepsy. No significant ~~ difference was found in blood status, except for a lower serum creatinine level in the patients. Current antiepileptic drug (AED) therapy appeared significantly associated with lower hemoglobin and creatinine levels and higher highdensity lipoprotein values. The patients perceived their health status to be comparable with that of controls, irrespective of physical inactivity, continued seizures, or AED monotherapy. However, patients receiving AED polytherapy perceived their health as rather poor or very poor significantly more often than did controls.Conclusions: Based on objective muscle tests, adults with childhood-onset "epilepsy only" have poorer physical fitness than do matched controls, but they have a feeling of good personal health.