Convulsive Disorders in the First Year of Life: Neurological and Mental Outcome and Mortality

Abstract

Mortality and neurological and mental outcome were studied in infants 28 days-1 yr old with afebrile seizures not due to an acute postnatal injury. Cases were divided into 4 seizure types: infantile spasms; status epilepticus; and others (patients without spasms or status), generalized and partial. Mortality was studied in 334 cases, mental and neurological prognosis in 313 infants followed 1 yr or more. Globally the prognosis was very poor even outside cases of infantile spasms. Mortality was higher and mental and neurological sequelae were more common in symptomatic than in cryptogenic cases. The highest mortality and greatest number of neurological defects were in status epilepticus and in others partial groups. Severely retarded subjects were more common in infantile spasms and others partial. The proportion of mentally normal patients was no different according to ictal type. Mental and neurological prognosis was less unfavorable when the 1st seizure occurred at or over 6 mo. A family history of epilepsy or febrile convulsions (21% of the cases in the whole series) was more common in the others subgroups, especially in the cryptogenic others (42%). The less unfavorable outcome obtained in cryptogenic others generalized with a positive family history.