Prognosis in Childhood Epilepsy

Abstract

One hundred and forty-eight epileptic children, seizure free for four years on anticonvulsant medication, were followed for five to 12 years after drug withdrawal to determine the frequency of relapse and to discern any prognostic criteria. Seizures recurred in 36 (24 per cent). There was no relation of relapse to sex, race, heredity, puberty or seizure frequency. With an early age at onset of epilepsy and prompt seizure control the recurrence rate was 13 per cent. It was at least twice as high in cases with a late onset, prolonged duration and neurologic, psychologic or electroencephalographic abnormalities. Relapse rates were lowest in grandmal attacks (8 per cent), febrile seizures (12 per cent) and petit-mal epilepsy (12 per cent). In psychomotor attacks the relapse rate was 25 per cent. The highest rate was in children with jacksonian seizures (53 per cent) and multiple seizure types (40 per cent). In a large percentage of selected cases these data support a favorable outcome after drug withdrawal in children having prolonged seizure control.