A follow-up study of 1007 epileptic children with anticonvulsant therapy
Tsuchiya, S.; Maruyama, H.; Maruyama, K.; Fukuhara, M.; Maeda, R.; Kanematsu, S.
No to Hattatsu 17(1): 23-28
1985
ISSN/ISBN: 0029-0831 PMID: 3970777 Document Number: 260692
A follow up study was performed on 1007 epileptic children with respect to natural history, prognostic factors, and remission and relapse rates in the Matsudo Clinic [Japan]. They were first diagnosed at ages less than 15 yr and were followed up for 13 yr on an average. Anticovulsants were tapered off after the patients had had no seizures for at least 3 yr and no seizure discharges in EEG for 1 to 2 yr. Fifty-one patients (5%) died during the period of this study, and 407 (43%) out of 956 living patients were medication-free without relapse for 1 to 15 yr (mean: 5 yr). There were 285 patients (30%) who had been seizure-free but dependent on medication or reducing the dosage of medication, and 264 patients (27%) were seizure-free for less than 5 yr. The remission rate was 71% for the 5 yr period. The relapse rate was 8% after discontinuation of drugs. Factors for favorble outcome were as follows: grand mal, absence seizures and simple partial seizures; no neurologic complication; normal mentality; less than 5 yr between the first and the last seizures; seizure control by the age of 10 yr; disappearance of epileptic discharges in EEG by the age of 15 yr. On the contrary, factors of poor outcome were as follows: Lennox-Gastaut syndrome, myoclonic seizures and complex partial seizures; some neurologic deficits; mental retardation the onset of seizures after 10 yr; severe EEG abnormalities.