Long-Term Follow-Up of Patients With Petit Mal

Abstract

T HE PRESENT paper is based on a longterm study of 275 patients with petit mal. In this study an attempt was made to assess the incidence and character of other forms of epilepsy as they occur in patients with petit mal, to report the results of psychometric testing, and to obtain a critical insight into the problems of drug therapy and social prognosis for these patients. In addition, the genetic and other etiologic implications of the material will be discussed. Previous authors have covered some of these questions on the basis of smaller series.1-5 Their conclusions will be discussed in due course, as will also some common, but less well-documented, beliefs about petit mal. Report of CasesThe patients were drawn predominantly from the Seizure Clinic at the Columbia-Presbyterian Medical Center. The median duration of clinic attendance was eight years. More importantly, the ages to which patients were finally followed are given in Table 1, from which it is seen that the majority was followed be¬ yond the years of puberty; these years, as will be shown, are critical for the assessment of prognosis. In

Typical absence seizures in adults: clinical, EEG, video-EEG findings and diagnostic/syndromic considerations.

“…Juvenile absence epilepsy (JAE)2 2429 was the likely diagnosis in four patients (cases [11][12][13][14]. Two patients (cases 11 and 12) had typical absences with onset at puberty.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Loss or severe impairment of consciousness is considered to be the clinical hallmark of absences.2021 EEG manifestations of typical absences, however, are frequently associated with mild, inconspicuous cognitive impairment. 22.24 Furthermore, typical absences have been studied in a uniform fashion' 19 25 26 despite existing evidence that their clinical and EEG features are syndrome-related.…”

Polyspike and Waves Do Not Predict Generalized Tonic-Clonic Seizures in Childhood Absence Epilepsy

“…This is in contrast to previous studies that reported an evolution of generalized tonic-clonic seizures between 32% and 49%. 26,32–34 This discrepancy might be due to our relatively short average follow-up period of 5.4 years, because there is a second manifestation peak of generalized tonic-clonic seizures usually 5 to 10 years after onset. 33 In addition, our strict adherence to the criteria of the International League against Epilepsy and the exclusion of children with atypical absences might have further reduced the number of generalized tonic-clonic seizures in our sample.…”

Estados de mal epiléptico na síndrome de Lennox-Gastaut: 1 — aspectos clínicos

“…Embora apareçam em idades superiores à da instalação da síndrome, tais estados são mais precoces que os observados na epilepsia generalizada primária 4 . 5 . Outra diferença foi a falta de automatismos elaborados e a elevada incidência de hipotonia.…”