Symptomatic or cryptogenic partial epilepsy of childhood onset: fourteen-year follow-up

Ákos Szabó, C; Rothner, A.David; Kotagal, Prakash; Erenberg, Gerald; Dinner, Dudley S; Wyllie, Elaine

« Previous Next »Pediatric Neurology
Volume 24, Issue 4 , Pages 264-269, April 2001

Symptomatic or cryptogenic partial epilepsy of childhood onset: fourteen-year follow-up

This study was presented as a poster at the Child Neurology Meeting in Baltimore, MD, in October 1995 (Ann Neurol 1995;38:529).

C Ákos Szabó, MD
- Division of Neurology; University of Texas Health Science Center; San Antonio, Texas, USA
- Communications should be addressed to: Dr. Szabó; Division of Neurology; University of Texas Health Science Center At San Antonio; 7703 Floyd Curl Drive; San Antonio, TX 78284-7883
A.David Rothner, MD
- Department of Neurology; The Cleveland Clinic Foundation; Cleveland, Ohio, USA
Prakash Kotagal, MD
- Department of Neurology; The Cleveland Clinic Foundation; Cleveland, Ohio, USA
Gerald Erenberg, MD
- Department of Neurology; The Cleveland Clinic Foundation; Cleveland, Ohio, USA
Dudley S Dinner, MD
- Department of Neurology; The Cleveland Clinic Foundation; Cleveland, Ohio, USA
Elaine Wyllie, MD
- Department of Neurology; The Cleveland Clinic Foundation; Cleveland, Ohio, USA

Received 20 March 2000; accepted 15 January 2001.

Abstract

This study reports on the seizure and psychosocial outcome of 29 patients with electroclinically well-defined childhood-onset symptomatogenic or cryptogenic partial epilepsy with complex partial seizures who were followed prospectively over 14 years. Many were refractory at the time of enrollment. At 14-year follow-up, we acquired information on seizure type and frequency, psychiatric history, substance abuse, criminal activity, in addition to educational, vocational, and marital status through chart reviews and/or structured telephone interviews. Sixteen patients were only treated medically. They were divided by their following responses to medications: eight patients with less than one seizure per month were in the medically responsive group and eight patients with at least one seizure per month constituted the medically refractory group. Thirteen patients underwent focal resection for medically refractory epilepsy. Medically refractory patients displayed worse educational, vocational, social, and behavioral outcomes than medically responsive patients. Behavioral abnormalities persisted or evolved in five medically refractory patients when they became seizure free. Other studies have indicated that patients with medically refractory complex partial seizures have poor psychosocial outcomes. Although behavioral problems can occur even when seizures are well controlled, their early detection and treatment may be essential to the improvement of psychosocial outcomes.