Management of Childhood-onset Epilepsy Evaluated with a Long-term Follow-up Study

• Published in: Epilepsy & Seizure Vol. 1; no. 1; pp. 21 - 29
• Main Authors: Namba, Masanori, Ohtsuka, Yoko, Oka, Makio, Yoshinaga, Harumi, Endoh, Fumika, Kobayashi, Katsuhiro
• Format: Journal Article
• Language: English
• Published: JAPAN EPILEPSY SOCIETY 2008
• Subjects: Childhood-onset epilepsy; Long-term follow-up; Outcome; Relapse; Remission
• ISSN: 1882-5567; 1882-5567
• DOI: 10.3805/eands.1.21

Purpose: While many patients with childhood-onset epilepsy go into remission before reaching adulthood, a significant number of patients continue to suffer from refractory epilepsy. The purpose of this study was to clarify the long-term outcome of childhood-onset epilepsies. Subjects and Methods: We retrospectively studied 445 adult patients with childhood-onset epilepsies who were still being treated at the Department of Child Neurology, Okayama University Hospital. Results: Age at onset of epilepsy was < 7 years in 66% of the patients; 7 to 14 years in 30%; and 15 to 19 years in 5%. We classified the subjects into three groups: Group PE (289 patients) with partial epilepsy; Group GE (60 patients) with generalized epilepsy; Group RE (70 patients) consisting of patients with a history of West syndrome, Lennox-Gastaut syndrome, Doose syndrome and related epileptic syndromes; and 26 other unclassified cases. At follow-up, frequent seizures (≥ per month) were observed in 26%, 13% and 63% of patients in Groups PE, GE and RE, respectively. Of 168 patients in remission across these three groups, AEDs were discontinued or being reduced in 21% each, while 36% had experienced relapse of seizures, mainly caused by AED withdrawal. Discussion: This study indicated that these adult patients could be classified into two types: patients who still have frequent seizures even after reaching adulthood, and patients in remission or with rare seizures. For long-term management of these patients, an efficient system with cooperation between medical and comedical staff, and a comprehensive care system are essential.