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[EEG analysis and prognosis in 125 cases of non-hyperpyretic seizures occurring in children under three (author's
Insights
Early epileptic seizures in infants under one year old are linked to a higher risk of fatal outcomes. However, intellectual development in survivors is not affected by seizure timing, though overall prognosis remains poor.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Neurophysiology
Context:
- Longitudinal study of 125 children (1-36 months) experiencing their first non-hyperthermic epileptic seizure.
- Follow-up data available for 100 children over 5-20 years.
- Analysis of seizure onset age (before 1 year vs. 1-3 years) and EEG patterns.
Purpose:
- To investigate the long-term prognosis and developmental outcomes of early childhood epilepsy.
- To correlate EEG findings with age of seizure onset.
- To assess the impact of seizure timing on mortality and intellectual development.
Summary:
- Hypsarrhythmia was more prevalent in children with seizures before age 1.
- Short diffuse spike and wave bursts were observed only after age 1.
- Localized spikes, asymmetrical/slow, or normal EEG tracings showed no significant difference between age groups.
- Fatal outcomes were more frequent in the younger group (seizure onset before 1 year).
- Intellectual development of survivors was independent of seizure onset age.
- Overall prognosis is unfavorable, with only 31% of followed children developing normally.
Impact:
- Highlights the critical impact of early-onset epilepsy on long-term outcomes, including mortality.
- Informs clinical management and counseling for families regarding epilepsy prognosis.
- Underscores the need for further research into factors influencing normal development in childhood epilepsy survivors.
Abstract:
Between 1955 and 1970 recordings were made from 125 children aged 1-36 months who had had a first epileptic seizure (non-hyperthermic). 100 of these children were followed up for from 5 to 20 years: 35 had had their first seizure before 1 year of age and 65 between the age of 1 and 3. Hypsarrythmia was more frequent under 1 year of age, whereas short diffuse spike and wave bursts were observed only after 1 year. However, localized spikes, asymmetrical or slow tracings as well as normal tracings were observed in both groups, without significant difference. A fatal outcome is more frequent when the first seizure took place before the age of 1 year. However, in our sample the intellectual development of the surviving children does not depend on the time of the first seizure. In any case the prognosis is unfavorable, since only 31 of the children followed up developed normally.