Long‐term Outcome in Children with Temporal Lobe Seizures* I: Social Outcome and Childhood Factors

Abstract

One hundred children, diagnosed as having temporal lobe epilepsy and reported on in 1966, were followed into adult life. In this 1977 survey they were coded into 4 social outcome categories, A, B, C and D: A: 33% were seizure-free and independent; B: 32% were socially and economically independent but were receiving anticonvulsant treatment and were not necessarily seizure-free; C: 30% were dependent either on their parents or in institutions; D: 5% died under the age of 15. Biological factors ascertained and coded in childhood were related to adult outcome. Eight adverse factors emerged: an IQ below 90, onset of seizures before 2 yr 4 mo., 5 or more grand mal attacks, temporal lobe seizure frequency of 1 per day or more, a left-sided focus, the hyperkinetic syndrome, catastrophic rage and special schooling. The presence of 1st-degree relatives with seizure disorders was a good prognostic sign. Disorderly homes in childhood did not significantly affect adult outcome. All but 1 of those achieving group A status had received normal schooling. The prognosis for children with limbic seizures is clear before the end of adolescence: a count of the number of childhood adverse factors predicts adult outcome at a high level of significance.