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Five-year follow-up of patients with partial epilepsies in infancy
A Okumura1, F Hayakawa, T Kato
1Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Insights
This study tracked infants with early-onset partial epilepsy, finding that most achieved seizure freedom and normal development. Key predictors of poor outcomes include developmental delay before seizures and abnormal EEGs.
Area of Science:
- Pediatric Neurology
- Epileptology
- Developmental Neuroscience
Background:
- Partial epilepsies in infancy present unique challenges for long-term outcome prediction.
- Understanding factors influencing seizure control and neurodevelopment is crucial for early intervention.
Purpose of the Study:
- To determine the long-term seizure and developmental outcomes for infants with partial epilepsies starting before age two.
- To identify clinical and EEG factors associated with these outcomes.
Main Methods:
- A cohort of 39 infants with partial epilepsy onset by age two was followed until at least age five.
- Outcomes were assessed for seizure freedom and normal development.
- Correlations were examined between outcomes and pre-seizure developmental delay, EEG abnormalities, neuroimaging, family history, and neonatal seizures.
Main Results:
- 33 infants (85%) achieved seizure freedom, and 27 (69%) achieved normal development.
- Pre-seizure developmental delay and abnormal interictal EEG predicted poor seizure and developmental outcomes.
- Abnormal neuroimaging predicted poor seizure outcome; neonatal seizures and lack of family history predicted poor developmental outcome.
- A predictive model combining four factors demonstrated high sensitivity (0.79) and specificity (0.87) for normal outcomes.
Conclusions:
- Long-term outcomes for infantile partial epilepsy are generally better than previously reported.
- Specific factors, including early developmental delay and EEG findings, are critical for predicting outcomes.
- A combination of key factors offers a reliable tool for outcome prediction in this population.
Abstract:
The aim of this study is to clarify the long-term outcome of patients with partial epilepsies that begin in the first 2 years of age. Thirty-nine infants who experienced partial epilepsies with onset by 2 years of age were followed until they were at least 5 years of age. Seizure and developmental outcome were investigated in relation to the following items: delayed psychomotor development before onset of seizures; interictal electroencephalogram (EEG) abnormalities; abnormal neuroimaging; family history of epilepsy; and history of neonatal seizures. Thirty-three infants achieved freedom from seizures and 27 achieved normal development. Delayed development before the onset and abnormal interictal EEG correlated with both poor seizure and developmental outcome. Abnormal neuroimaging findings correlated with a poor seizure outcome. A history of neonatal seizures and lack of a family history of epilepsy correlated with poor developmental outcome. The combination of the first four factors predicted a normal outcome with a sensitivity of 0.79 and a specificity of 0.87. The seizure and developmental outcomes were better in this study than those in previous studies. The combination of the four factors will be useful for predicting the outcomes in patients with partial epilepsies in infancy.