Prognosis of Childhood Epilepsy: A Community-Based Study in Copparo, Italy

Abstract

We performed a community-based study among children and adolescents with idiopathic and cryptogenic epilepsy and onset of the seizures between 0 and 19 years of age on the prognosis of being seizure-free. The study population was recruited during a descriptive investigation in the Local Health Service of Copparo (USL 34), Ferrara, Northern Italy. We included 111 patients (61 males and 50 females). The average length of follow-up was 18.8 years (ranging from 7 to 24 years). The cumulative probability of being in remission was 81.2% at 15 years after onset and the estimated percentage of patients in remission without therapy was 56 % for the same time period. At 15 years after the onset of epilepsy, approximately 20% of patients continued to have seizures; nearly 25% continued to take antiepileptic drugs but had been free of seizures for at least 5 years; nearly 56% had been without seizures and free of medication for at least 5 years. Seizure type, gender, age at onset of the illness, epileptic abnormalities on EEG, family history of convulsive disorders, number and frequency of seizures prior to the start of treatment were found not to be helpful as prognostic factors. This community study, carried out on patients without the well known factors that adversely affect prognosis, confirms that the prospect of seizure control and for withdrawal of therapy is (generally) good.

Association of epilepsy with different groups of microcephaly

“…Interestingly, there was a significantly higher prevalence of epilepsy in males in the total participants as well as in the groups with IMC and SMC. This higher prevalence in males has also been seen in many prospective studies of epilepsy (Casetta et al 1997, Ohki et al 1997, Ojuawo and Joiner et al 1997, Tekle-Haimanot et al 1997, Doose et al 1998). However, this result needs further investigation to determine whether it is a general characteristic of MC or a chance effect.…”

Children with epilepsy after withdrawal of anticonvulsive therapy: psychiatric behaviour and neuropsychological abilities

“…Many studies in the literature deal with the question of relapse frequency and the time at which they occur in children with epilepsy after withdrawal of anticonvulsive therapy [11]. In addition, a number of risk factors for relapses are mentioned [7].…”

“…In the literature, the long-term outcome of epilepsy in childhood is limited to the description of the treatment prognosis. According to dierent investigators, permanent seizure freedom is achieved in 70%±80% of all paediatric epileptic patients [11]. Numerous studies were able to demonstrate a correlation between classi®cation of epilepsy and longterm outcome.…”

The epidemiology of the epilepsies in children

“…The percent of children with cryptogenic epilepsy reported to be free of seizures for at least 5 years within the first 10 years after their initial diagnosis is approximately 70% to 80% [Annegers et al, 1979a;Casetta et al, 1997]. A more recent study followed children with onset of epilepsy in the early 1960's for nearly 30 years and reported the probability of remission (seizure-free for 5 years with or without medication) at the time of last follow-up as 64% for the entire case group [Sillanpaa, 2000].…”