Epidemiologic aspects: lost in transition

Population-based studies focusing on the long-term prognosis of childhood-onset epilepsy show that despite seizure remission in 70-80% of cases, cognitive, behavioral and psychosocial complications are common and will require management and monitoring in adulthood. This type of study design also demonstrates that death is rare in children who are intellectually and neurologically normal and followed for many years, which is the same for the general population. Only those children with neurologic problems sufficiently severe to interfere with activities of daily living have an increased risk of death in childhood. Investigation of potentially remediable complications is paramount, and the use of antiepileptic medications with potential adverse cognitive and behavioral effects should be identified and eliminated or reduced. In addition, education of the family should be improved. As well, identification and control of social and psychiatric complications is necessary and implies a comprehensive management of the patient before and after the transition from childhood into adulthood.