Related Experiment Videos
Prognosis of childhood epilepsy: a community-based study in Copparo, Italy
I Casetta1, E Granieri, V C Monetti
1Institute of Neurological Clinic, University of Ferrara, Italy.
Insights
Children and adolescents with epilepsy often achieve long-term seizure control. Over half of patients in this study achieved remission without antiepileptic drugs, indicating a good prognosis for seizure freedom.
Area of Science:
- Neurology
- Pediatric Neurology
- Epileptology
Background:
- Idiopathic and cryptogenic epilepsy in children and adolescents represent a significant neurological challenge.
- Understanding the long-term prognosis of seizure control and medication withdrawal is crucial for patient management.
Purpose of the Study:
- To evaluate the long-term prognosis of seizure freedom in a community-based cohort of children and adolescents with epilepsy.
- To determine the probability of remission and successful antiepileptic drug withdrawal.
Main Methods:
- A community-based descriptive study was conducted in Ferrara, Italy.
- 111 patients (onset 0-19 years) with idiopathic/cryptogenic epilepsy were followed for an average of 18.8 years.
- Prognostic factors including seizure type, gender, age at onset, EEG, family history, and pre-treatment seizure characteristics were analyzed.
Main Results:
- The cumulative probability of being seizure-free at 15 years post-onset was 81.2%.
- At 15 years, 56% of patients achieved remission without antiepileptic drugs.
- Approximately 20% continued to have seizures, while 25% remained seizure-free on medication.
Conclusions:
- The long-term prognosis for seizure control and potential medication withdrawal in pediatric epilepsy is generally favorable.
- Commonly assessed prognostic factors did not significantly predict seizure outcomes in this cohort.
- This study supports the potential for good seizure control and successful discontinuation of therapy for many young epilepsy patients.
Abstract:
We performed a community-based study among children and adolescents with idiopathic and cryptogenic epilepsy and onset of the seizures between 0 and 19 years of age on the prognosis of being seizure-free. The study population was recruited during a descriptive investigation in the Local Health Service of Copparo (USL 34), Ferrara, Northern Italy. We included 111 patients (61 males and 50 females). The average length of follow-up was 18.8 years (ranging from 7 to 24 years). The cumulative probability of being in remission was 81.2% at 15 years after onset and the estimated percentage of patients in remission without therapy was 56% for the same time period. At 15 years after the onset of epilepsy, approximately 20% of patients continued to have seizures; nearly 25% continued to take antiepileptic drugs but had been free of seizures for at least 5 years; nearly 56% had been without seizures and free of medication for at least 5 years. Seizure type, gender, age at onset of the illness, epileptic abnormalities on EEG, family history of convulsive disorders, number and frequency of seizures prior to the start of treatment were found not to be helpful as prognostic factors. This community study, carried out on patients without the well known factors that adversely affect prognosis, confirms that the prospect of seizure control and for withdrawal of therapy is (generally) good.