Abstracts

Rationale: All parents of epileptic children would like to have a prognosis concerning the course of the disease and the chances of development for their children. For counselling them only a few data are available concerning follow-ups longer than five years. Methods: We analysed 167 patients (89 female, 78 male)who had been treated in our clinic between 1990-94 as in-patients. Mean age 11,5 y, duration of epilepsy 7,6 y. 90,9% had been treated with 1 or 2 antiepileptic drugs, 6,7% with 3 or more. 68,2% had a focal epilepsy, 19,1% a generalized epilepsy. In 12,7% we couldn't make an exact classification. We registered the etiology (symptomatic 78,9%) seizure types and frequency (53,9% had seizures daily)and medication as well as other data about concomitant diseases. 75,1% of our patients had mild to severe cognitve impairment or are physically handicapped. Results: A control by questionnaire and in some patients telephone calls were done in 2005. So the follow-up was 10-15 years. 40.4% of all patients became seizure free (for more than 3 years). Patients with generalized epilepies (53,8%) more often than those with focal epilpesies (25,3%). Patients who underwent epilepsy surgery were excluded. 38,5% still had seizures weekly. Risk factors are: background-slowing in the EEG (odds ratio 6,2),tonic seizures (8,2),seizure-frequence more than 1/mo (8,6), series of seizures (6,9). For the succes at school seizure frequence is less important than cognitive impairment. Even 6,9% of all patients with daily seizures at the time of control could finish a regular school. Conclusions: The results show that the prognosis even in children who continue to have seizures is not as bad as supposed. We could identify several risk factors which make a bad prognosis for exampe tonic seizures or EEG background slowing. Nevertheless one should encourage the parents to continue the medical treatment and support their children especially if they have concomitant diseases.