Prognostic factors of primary generalized epilepsy: a reappraisal of 96 cases in terminal remission

Ninety-six patients whose diagnosis was definitively confirmed as primary generalized epilepsy (PGE) were divided into two groups according to the duration of recurrent seizures--A group for less than 7 years and B group for more than 7 years. The patients of both groups were completely free of seizures for more than 3 years at the time of the survey. A retrospective comparison was made between these two groups in terms of clinical and EEG features. Emphasis was placed on the B group which was characterized by an unfavorable seizure outcome. From a prognostic point of view, the risk factors indicative of an unfavorable outcome of seizures were found as follows: a) the presence of generalized tonic-clonic convulsions (GTCs) prior to the occurrence of minor seizures and persisting GTCs following the subsidence of minor seizures, b) scanty epileptic EEG findings in spite of the sporadic occurrence of GTCs, and c) GTCs tended to associate with various seizure-inducing factors. As a conclusion, along with appropriate drug treatment, the necessity of comprehensive approaches to the patients' everyday life was emphasized in order to achieve a favorable seizure outcome.