Related Experiment Videos
A follow-up study of intractable seizures in childhood
1Department of Pediatrics, University of Chicago, IL 60637.
Insights
Children with medically refractory seizures often have intellectual disability, with earlier onset in those with mental retardation. Borderline to normal intelligence correlated with higher seizure remission rates over time.
Area of Science:
- Pediatric Neurology
- Developmental Neuroscience
Background:
- Epilepsy in children presents significant challenges, particularly when seizures are refractory to medical treatment.
- Long-term outcomes for children with intractable epilepsy are not fully understood, especially concerning intellectual development and seizure remission.
Purpose of the Study:
- To investigate the long-term prognosis of children with medically refractory seizures.
- To explore the relationship between intellectual functioning, age of seizure onset, and seizure remission.
Main Methods:
- A longitudinal follow-up study of 145 children with seizures refractory to medical therapy for at least 2 years.
- Assessment of intellectual functioning (mental retardation vs. borderline to normal intelligence).
- Tracking of seizure remission over a 5 to 20-year period post-onset.
Main Results:
- The majority of children (61%) with uncontrollable seizures had mental retardation, with 73% experiencing onset before age 2.
- Children with borderline to normal intelligence had a significantly later age of seizure onset (mean 5.0 years).
- Seizure remission occurred at a rate of approximately 4% per year in children with borderline to normal intelligence, compared to only 1.5% per year in those with mental retardation.
Conclusions:
- Intellectual functioning is a critical factor influencing long-term seizure remission in children with refractory epilepsy.
- Early-onset seizures (<2 years) are strongly associated with mental retardation in this cohort.
- While seizure type and brain lesions had some impact, intellectual status appeared to be a more significant predictor of long-term seizure control.
Abstract:
One hundred forty-five children with seizures that were refractory to medical therapy for at least 2 years were followed 5 to 20 years after onset. The majority of children with uncontrollable seizures (61%) were mentally retarded, and most of these (73%) had onset of seizures at younger than 2 years of age. Age of onset was significantly later (mean 5.0 +/- 0.5 yr [SEM]) in the group of children with borderline to normal intelligence. Follow-up data showed remission of seizures in a significant proportion of children with borderline or normal intelligence, with a linear decrease of the percentage with persistent seizures at a rate of about 4% per year. Remission of seizures was much less frequent (1.5%/yr) in the group with mental retardation. Seizure type had some effects on outcome. Children with focal atrophic brain lesions did no worse than those without definable pathology on brain-imaging studies.