The long-term course of primary generalized epilepsy with persisting absences

The long-term course of primary generalized epilepsy with absences persisting after the age of 30 to 61 years was studied in 26 patients, each followed clinically and by EEG for 20 to 37 years. Whether treated or not, absences became less frequent, but only rarely ceased, and 92% of patients with persisting absences eventually developed generalized convulsions. EEG background activity did not deteriorate, and the classic spike and wave complexes remained typical in 84% of patients. In 36% of cases, almost all of them women, psychomotor slowing was observed, which did not affect job performance. It was not related solely to duration or severity of epilepsy, or to antiepileptic drugs, and some hormonal mechanism may be partly responsible.