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PubMed2001

Epilepsy in children with cerebral palsy.

OBJECTIVE: To describe the prevalence and characteristics of epilepsy in patients with cerebral palsy in a tertiary center. METHODS: a total of 100 consecutive patients with cerebral palsy were retrospectively studied. Criteria for inclusion were follow-up period for at least 2 years. Types and incidence of epilepsy were correlated with the different forms of cerebral palsy. Other factors associated with epilepsy such as age of first seizure, neonatal seizures and family history of epilepsy were also analysed. RESULTS: follow-up ranged between 24 and 151 months (mean 57 months). The overall prevalence of epilepsy was 62%. Incidence of epilepsy was predominant in patients with hemiplegic and tetraplegic palsies: 70.6% and 66.1%, respectively. First seizure occurred during the first year of life in 74.2% of patients with epilepsy. Generalized and partial were the predominant types of epilepsy (61.3% and 27.4%, respectively). Thirty-three (53.2%) of 62 patients were seizure free for at least 1 year. Neonatal seizures and family history of epilepsy were associated with a higher incidence of epilepsy. CONCLUSIONS: epilepsy in cerebral palsy can be predicted if seizures occur in the first year of life, in neonatal period and if there is family history of epilepsy.

Adolescent↗
PubMed2005

Involvement of taurine in penicillin-induced epilepsy and anti-convulsion of acupuncture: a preliminary report.

The potential role of taurine on epilepsy and acupuncture anti-convulsion was addressed in the present study. Epilepsy was induced by micro-injection of penicillin into hippocampus of Wistar rats. Taurine was applied by intraperitioneal (i.p.) injection. Electro-acupuncture (EA) was performed on acupoints of DU 20 "Bai Hui" and DU 16 "Feng Fu" along DU channel. Epileptic grades were evaluated by electro-encephalography (EEG) and behavior score. We featured the dose-response relationship between taurine-treated epilepsy and epilepsy-only subjects, detected the effect of exogenous taurine on epilepsy and acupuncture treatment, and investigated taurine transporter immuno-activity in hippocampus using immunohistochemistry. It was found that: 1), taurine had a significant antiepileptic effect as applied at i.p. 20 mg/kg, 40mg/kg, 80mg/kg, especially at 40mg/kg in the rat model of penicillin-induced seizure. Animals were improved by one to three Racine grades in behavior and in frequency and amplitude of EEG. 2), Exogenous taurine enhanced the anti-convulsive effect of EA. Both behavior and EEG were improved in taurine-treated rats. EA inhibited epilepsy. Exogenous taurine improved epilepsy in a synergistic manner to EA. 3), EA increased the concentration of taurine transporter in hippocampus by comparing EA-treated epilepsy with normal control and penicillin only, or EA-treated plus taurine-treated epilepsy with taurine-treated only epilepsy and penicillin only. The resulting data suggested that taurine may play an inhibitory role against epilepsy as an inhibitory amino acid in the central nervous system and EA may inhibit epilepsy via upregulating the concentration of taurine transporter to increase the release of taurine.

Acupuncture Therapy↗
PubMed2003

[Genetics of epilepsy].

Epilepsy is a common neurological disease and encompasses a variety of disorders with paroxysms. Although there is a genetic component in the pathogenesis of epilepsy, the molecular mechanisms of this syndrome remain poorly understood. The identification of genes responsible for human epilepsy was first documented in progressive myoclonic epilepsy (EPM) because of their clear inheritance and phenotypic presentation. EPM is characterized by frequent myoclonic jerks and cumulative neurological deterioration and includes MERRF, a mitochondrial disease and DRPLA, a triplet disorder. The genes responsible for EPM seem to participate in the maintenance of cell viability. Genetic defects have been recently identified also for some familial epilepsy in which the phenotypes are similar to common idiopathic epilepsies. Defects of neuronal nicotinic acetylcholine receptor, a ligand-gated ion channel, caused nocturnal frontal lobe epilepsy. Mutations of two K(+)-channel genes were identified in benign familial neonatal convulsions. Mutations in the voltage-gated Na(+)-channel alpha 1, 2 and beta 1 and the GABAA receptor gamma 2 subunit genes were found as a cause of dominant epilepsy with febrile seizures plus, a clinical subset of febrile seizures. Abnormalities of Na(+)-channel alpha 1 subunit were also associated with severe myoclonic epilepsy in infancy. Other genes encoding ion channels expressed in the brain were also found to be associated with other familial epilepsy. This line of evidence suggests the involvement of channels expressed in the brain in the pathogenesis of certain idiopathic epilepsy, albeit there are a few exceptions that abnormalities of non-channel molecules have been found to be associated with idiopathic epilepsy.

Brain↗
PubMed2003

[Epilepsy and genetics].

The inheritance of epilepsy has been known since antiquity. Twin studies have shown that genes are important, particularly in primary generalised epilepsies, although the overall risk of epilepsy in offspring of parent with epilepsy is only approximately 6%. Many different protein structures control the normal activation of a brain neurone, and genes are responsible for the structure of these proteins. Mutations can lead to the characteristic pathological activation of epileptic neurones. Monogenic epilepsies may be related to changes in structures of importance for neuronal activation, e.g. the Na channel, the K channel, the GABA-A receptor, and in an acetylcholine receptor. A mutation has been demonstrated in a gene possibly related to brain development. Most likely, many primary epilepsies are polygenic. Epilepsy is also a part of many other genetic diseases. Susceptibility genes may be of importance for the development of certain epilepsies. De novo mutations may also occur. Studies in families with epilepsy may lead to the discovery of more monogenic epilepsies. Comparison between large populations of patients and controls is necessary in order to identify susceptibility genes in non-familiar epilepsy. The new knowledge of genetic aspects of epilepsy will bring improvements in diagnostics and treatment.

Brain↗
PubMed2004

[Prognostic factors in temporal lobe epilepsy surgery].

INTRODUCTION: Temporal lobe epilepsy surgery represents the majority of surgical interventions in patients with refractory epilepsy. In consequence, knowledge of prognostic factors in this type of epilepsy surgery is of major importance. The objective of this study is to study series of prognostic factors in a group of patients who underwent temporal lobe epilepsy surgery and to correlate Engel's Classification of Postoperative Outcome, now used in most epilepsy centers, and the Proposal for New Classification in regards to Epileptic Seizures Following Epilepsy Surgery of the International League Against Epilepsy (ILAE). METHODS: We analyzed 41 consecutive patients who underwent temporal lobe epilepsy surgery in the Epilepsy Surgery Program of the Epilepsy Unit in the Fundación Jiménez Díaz. The following prognostic factors were analyzed: age at surgery, time since the first seizure (excluding febrile seizures), risk factors for the development of epilepsy, presence of simple partial seizures, presurgical complex partial seizure frequency, findings in brain magnetic resonance imaging, interictal and ictal electroencephalogram, neuropsychological assessment, Wada test and neuropathological study of the surgical specimen. Two outcome classifications were used: Engel's classification of postoperative outcome and the proposal for a new classification of outcome in regards to epileptic seizures following epilepsy surgery of the ILAE. Statistical analysis was performed using non-parametric tests. RESULTS: The presence of temporal unilateral interictal epileptiform activity and the presence of less than 20 seizures complex partial seizures per month before surgery were associated with a better prognosis using both classifications. The electronencephalographic unilateral temporal ictal onset recording was associated with a better prognosis using Engel's classification but not ILAE's outcome classification. The presence of febrile seizures was associated with a better prognosis in regards to ILAE's outcome classification but not in regards to Engel's classification. The remaining factors were not associated with outcome. CONCLUSIONS: The following factors were associated with a good prognosis: presence of unilateral temporal interictal epileptiform activity, presurgery seizure frequency below 20 complex partial seizures per month, unilateral temporal ictal onset, and presence of febrile seizures. A good correlation was found between both outcome classifications in regards to most of the analyzed prognostic factors.

Adult↗
PubMed2004

The choice of antiepileptic drugs in newly diagnosed epilepsy: a national French survey.

The choice of an antiepileptic drug (AED) in patients with epilepsy is mainly based on efficacy and safety of each drug. However, these criteria of drug selection should be further evaluated according to the epileptic syndromes, and adjusted to the sex and age of the patient. Unfortunately, very few studies have been conducted based on these latter criteria. We conducted a survey on the management of epilepsy treatment in adults. This survey was undertaken in France, and led to the establishment of a French consensus on antiepileptic drug treatment in adult patients with newly diagnosed epilepsy. Patients were grouped into 18 categories according to the epileptic syndrome (absence epilepsy, juvenile myoclonic epilepsy, undetermined idiopathic generalized epilepsy, symptomatic or cryptogenic partial epilepsy and unclassified epilepsy), and to the patient's gender and age. Our survey suggests that there is a consensus among French epileptologists for the choice of AEDs, mainly based on the epilepsy syndrome. Gender also plays a crucial role. Sodium valproate and lamotrigine are the two drugs of choice for generalized epilepsies, as well as for undetermined epilepsies. Lamotrigine is often prefered for women of childbearing age. First line AEDs in partial epilepsy are carbamazepine (particularly for men), lamotrigine (particularly for women), and gabapentin (in the elderly). In cases of failure and/or intolerance to one of these AED, the principal alternatives are oxcarbazepine, sodium valproate and topiramate.

Adolescent↗
PubMed2004

[Social aspects of epilepsy: marriage, pregnancy, driving, antiepileptic drug withdrawal and against social stigma].

Persons with epilepsy need adequate advice and effective counselling about issues such as marriage, pregnancy, risks of inheriting epilepsy, driving, employment and antiepileptic drug withdrawal, because these persons are not receiving important information and education about their condition and possible adverse effects of treatment. Furthermore, women with epilepsy have increased rates of pregnancy complications and poor fetal outcomes including congenital malformations and developmental delay related to both their epilepsy and antiepileptic drugs. However, approximately 90% of all women with epilepsy undergo normal pregnancy and give birth to children free of birth defects. Pregnancy is generally safe in women with epilepsy. The study of long-term prognosis of childhood-onset epilepsy in Japan shows that the majority of these patients have lower levels of educational background as well as employment and marital status compared with the general population (Wakamoto H. et al). Of patients with epilepsy, 60% to 70% achieve control with antiepileptic medication. However, several antiepileptic drug withdrawal studies show variable rates of success, with relapse rates ranging from 12% to 63% (Britton J.W.). Driving is listed as major problem in persons with epilepsy. However, the patients with seizure-free more than two years have been able to get the driver's license since June, 2002. Social attitudes towards epilepsy cause more distress to the patient than the disease itself. We should realize that persons with epilepsy are normal or near-normal. To ameliorate the social stigma against epilepsy, continuous and repetitive educational efforts would be needed.

Anticonvulsants↗
PubMed1991

[Myoclonus and epilepsies in children].

The possible associations of myoclonic phenomena, progressive or non progressive encephalopathies and epileptic phenomena are reviewed with special emphasis on childhood. This leads to the following five groups of conditions: (1) myoclonus without encephalopathy and without epilepsy; (2) encephalopathies with non-epileptic myoclonus; (3) progressive encephalopathies with myoclonic seizures or epileptic syndromes (Progressive myoclonus epilepsies); (4) epileptic encephalopathies with myoclonic seizures; (5) myoclonic epilepsies. In the first group, which also includes physiological myoclonus, a more thorough description of "benign sleep myoclonus of newborn" and "benign myoclonus of early infancy" is given. Characteristic of group 2 are "Kinsbourne syndrome" and certain types of "Hyperekplexia" which pose interesting differential diagnosis problems with stimulus-sensitive epilepsies. In group 3, the concept of progressive encephalopathies is stressed, meaning that "Progressive Myoclonus Epilepsies" are always in fact progressive encephalopathies presenting with myoclonic types of seizures or epileptic syndromes among other neurologic and psychologic signs and symptoms. Major and rare causes are reviewed. The term major is applied to typical features or to frequency, whereas rare causes include not only those what are rarely seen, but also some myoclonic variants of diseases which usually have different symptoms. The fourth group refers to severe epilepsies, mainly in infancy and childhood, which lead to mental retardation irrespective of their cause. The assumption is that diffuse and persistent epileptic activity may interfere with normal development of the higher cerebral functions. "West syndrome" and "Lennox-Gastaut syndrome" are the more representative examples and may present with myoclonic type of seizures, but they are not dealt with in detail here. Group 5 comprises true myoclonic epilepsies, differentiating syndromes recognized as idiopathic, such as "benign myoclonic epilepsy of infancy" and "juvenile myoclonic epilepsy", from those which are cryptogenic and carry a more cautious prognosis--i.e.: "cryptogenic myoclonic and myoclono-astatic epilepsies" and "Severe myoclonic epilepsy of infancy". Finally other epileptic syndromes usually not considered as myoclonic epilepsies, but presenting sometimes myoclonic seizures, are mentioned.

Brain Diseases↗
PubMed1983

Profile of epilepsy in Lagos, Nigeria.

A total of 396 non-selected epileptic patients seen in Lagos University Teaching Hospital (LUTH) over a period of two years were clinically assessed and investigated for the purpose of classification; 378 were classifiable and 18 unclassifiable. About 25% of the classifiable patients had generalised epilepsy and 75% partial epilepsy. The commonest form of generalised epilepsy was grand mal and that of partial epilepsy was partial epilepsy with complex symptomatology. Seizure classification showed a similar pattern to that of epilepsies. The commonest form of generalised seizures were tonic-clonic seizures and those of partial seizures were complex partial seizures with simple partial onset, that secondarily generalised. Although the majority of patients with both generalised and partial epilepsies had seizure onset before the age of 20 years, a significantly higher percentage of patients with generalised epilepsy compared to partial epilepsy had seizures before the age of 10 years while a higher percentage of patients with partial epilepsy had seizures onset after the age of 10 years. The average age of onset of generalised epilepsy was lower than that of partial epilepsy.

Adolescent↗
PubMed1981

[Electro-clinical and developmental forms of epilepsy as a function of their appearance at different ages of life].

The authors review the different electroclinical varieties and the evolution of epilepsy that appear in the six principal age groups: newborn, infancy, childhood, adolescence, adult and aged. The aim of this study is to answer the following questions: on one hand to find out if there exists in newborn, infant or young child, a form of epilepsy entirely functional, dependent on a constitutional epileptic predisposition transmitted on a genetic basis, which correspond to the primary generalized epilepsy of the other age groups. If that is so, to find out this mode of expression. On the other hand, to confirm whether the proportion of primary generalized epilepsy varies according to the different ages of life, revealing a chance in the predisposition during life. The authors propose the following answers to the above-mentioned questions: there exists at birth a principally, functional form of epilepsy in relation to a constitutional predisposition. The usual electroclinical criteria are not applicable in this age group due to brain immadurity, so it is not possible to identify this variety. The progressive development of the brain in the infant and young child permits the clinical and electrical individualization of generalized fits as distinct from Petit or Gran Mal. These facts make it possible to confirm the existence of a principally functional epilepsy which corresponds to the primary generalized epilepsy of the adolescent and older child. The epileptic predisposition, principal factor responsible for primary generalized epilepsy, varies considerably during life. The authors presume that its incidence differs in each age group. Based on the frequency of hyperthermic fits in the infant and young child, the predisposition should be important in this age group, although the actual proportion of primary generalized epilepsy is difficult to quantify. In the older child it is possible to admit that the epileptic predisposition is greater because primary generalized epilepsy represents more than a third of the types of fits observed. This tendence is even greater in adolescence, where this form of epilepsy represents over three quarters of the patients. In the adult and aged patients, the epileptic tendency diminishes progressively, as can be seen comparing the proportion of primary forms of epilepsy with other types (25% young adult, 9% mature adult and 1% in the aged).(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1994

The epilepsies.

There is good evidence for a genetic causation of a significant proportion of the human epilepsies. These genetic epilepsies include a large number of rare mendelian syndromes in which epilepsy usually occurs as part of a more complex neurological phenotype, and the more common familial epilepsies in which seizures occur in isolation but inheritance is not mendelian. The molecular basis of these epilepsies is entirely unknown. The current revolution in genetics and neuroscience is, however, providing methods for the molecular genetic analysis of epilepsy. Two principal strategies exist. The first, positional cloning, requires localization of the disease genes by linkage analysis followed by analysis of transcripts within the disease-gene region. The second, candidate gene analysis, comprises direct screening of cloned genes which may on theoretical grounds have a role in epilepsy. At present, two epilepsy genes have been localized by linkage analysis: that for benign familial neonatal convulsions to chromosome 20, and that for progressive myoclonic epilepsy of Unverricht and Lundborg to chromosome 21. Linkage analysis of non-mendelian epilepsies is more difficult, but may be feasible with the generation of high-resolution linkage maps of the human genome. A number of plausible candidate genes for the epilepsies have now been cloned, including in particular the ligand-gated and voltage-gated ion channels. An understanding of the genetic epilepsies at a molecular level will provide new precision in diagnosis and genetic counselling, and may allow new strategies for pharmacological control of seizures.

Animals↗
PubMed1989

The localization-related epilepsies: some problems with subclassification.

One of the nosological problems of childhood epilepsies is the evolutionary change of foci with age. Benign childhood epilepsy with centro-temporal spike may evolve to show EEG features of childhood epilepsy with occipital paroxysms and vice versa. West syndrome is generally accepted as generalized epilepsy but is often preceded or followed by partial seizures and may have both partial seizures and tonic spasms in a single attack. Among epilepsies with both generalized and focal seizures, severe myoclonic epilepsy in infancy is more linked to generalized epilepsy whereas epilepsy with continuous spike-waves during slow wave sleep is more linked to localization-related epilepsy. Any type of partial epilepsy may develop nonconvulsive generalized seizures transiently with generalization of paroxysmal discharges during the clinical course. Moreover, nonconvulsive generalized seizures may occur even in localization-related epilepsy with spike-wave index during NREM sleep in less than 85%.

Adult↗
PubMed1999

Epidemiologic study of epilepsy in young Singaporean men.

PURPOSE: This survey of 20,542 Singaporean men born in 1974 studied the clinical features of young men diagnosed with epilepsy on preenlistment screening. METHODS: All male citizens in Singapore are medically screened at age 18 years before enlistment for compulsory military service. Patients suspected to have epilepsy are then referred to government hospitals for further management. We interviewed the patients and their parents and reviewed their hospital records. RESULTS: Eighty-nine patients with epilepsy were identified, indicating a lifetime prevalence of 4.9/1,000 males by age 18 years. The lifetime prevalence of epilepsy among Chinese, Malays, and Indians were 5.2, 2.8, and 6.4/1,000, respectively; these differences were not statistically significant. The mean age of seizure onset was 11.1 years. Generalized seizures (65.2%) were commoner than partial seizures (34.8%); common seizure types included generalized tonic-clonic seizures (52.8%), complex partial seizures with secondary generalization (24.7%), and myoclonic seizures (5.6%). Common epileptic syndromes included temporal lobe epilepsy (16.9%), juvenile myoclonic epilepsy (5.6%), and frontal lobe epilepsy (2.2%). Eighty-four (94.4%) patients sought medical treatment, and seven (7.9%) patients sought additional traditional treatment. Although 70 (78.7%) patients responded to medication, 14 (15.7%) patients remained refractory to treatment. CONCLUSIONS: The lifetime prevalence of epilepsy in young Singaporean men was 4.9/1,000. The majority (65.2%) had generalized seizures. Temporal lobe epilepsy was the commonest (16.9%) defined epilepsy syndrome. More patients with epilepsy (94.4%) sought medical treatment, although 15.7% remained refractory to medication.

Adolescent↗
PubMedDate not supplied

Myoclonus and epilepsies.

The possible associations of myoclonic phenomenae, progressive or non-progressive encephalopathies and epileptic features are reviewed, with special emphasis on pediatric age. This leads to recognize the following five groups of conditions: (1) Myoclonus without encephalopathy and without epilepsy; (2) Encephalopathies with non-epileptic myoclonus; (3) Progressive encephalopathies presenting myoclonus seizures of epileptic syndromes (Progressive myoclonus epilepsies); (4) Epileptic encephalopathies with myoclonic seizures; (5) Myoclonic epilepsies. Within the first group, which also includes physiologic myoclonus, a more thorough description of "Benign sleep myoclonus of newborn" and "Benign myoclonus of early infancy" is given. Characteristics of group 2 are "Kinsbourne Syndrome" and certain types of "Hyperekplexia" which pose interesting differential diagnosis with stimulus-sensitive epilepsies. In group 3, the concept of progressive encephalopathies is stressed. The fourth group refers to severe epilepsies, mainly on infancy and childhood, which lead to mental retardation irrespective of their aetiology. Group 5 comprises the true myoclonic epilepsies, differentiating syndromes recognized as idiopathic--such as "Benign myoclonic epilepsy of infancy" and "Juvenile myoclonic epilepsy"--from those which are cryptogenic and carry a more cautious prognosis--as "Cryptogenic myoclonic and myoclonoastatic epilepsies" and "Severe myoclonic epilepsy of infancy". Other epileptic syndromes not usually considered as myoclonic epilepsies, but presenting sometimes as myoclonic seizures, are finally referred.

Adolescent↗
PubMed2002

Socio-demographic characteristics of adolescents with epilepsy in Northern Jordan.

OBJECTIVE: The main objectives of this study were to determine the socio-demographic characteristics of epilepsy, and to compare these results with findings of comparable studies from other parts of the world. METHOD: Initially, the target population of this study consisted of 116 patients with epilepsy randomly selected, over a 6-month period, from those patients attending the neurology clinic at Princess Basma Teaching Hospital (PBTH) in Northern Jordan. However, seven patients were dropped from the study and eight others refused to participate in the study. A semi-structured clinico-epidemiological questionnaire was used to investigate the most significant socio-demographic characteristics of this group of adolescent Jordanian patients with epilepsy such as age, sex, living status, family history, type of epilepsy, and some other special clinical investigations. To further evaluate the significance of a family history of epilepsy, the education attainment and employment in these patients with epilepsy were compared with a similar number of age, sex matched control cases obtained from patients attending the hospital for reasons other than epilepsy. RESULTS: Among the study population, the mean age at presentation was 19 years (SD+/-2.7); 54 were males 47 were females. Fifty three patients had a poor level of education because they had less than 10 years of formal education, 29 had an average level of education (10-12 years) of formal education, and 19 had achieved a higher level of education. Thirty patients were employed, 21 unemployed and 50 were students. Twelve patients were living alone and leading independent lives, 88 patients were living with parents and siblings. One male patient was married and living with his wife and children. A positive family history was present in first degree relatives in 11 patients as compared to 3 in the control group. Ninety eight patients suffered from generalized epilepsy and three from partial epilepsy. Sixty seven patients reported an aura and 84 patients had post ictal complaints such as sleepiness, headache, or drowsiness. CONCLUSION: Socio-demographic characteristics of this group of adolescents with epilepsy are compatible with the results of the work of others such as Elwes [Neurosurg Psychiatr 54 (1991) 200], in the North East of England and Hauser from the Mayo clinic in his descriptive study of the epidemiology of epilepsy.

Activities of Daily Living↗
PubMed1991

Migraine in patients with history of centro-temporal epilepsy in childhood: a Hm-PAO SPECT study.

The authors report the results of a retrospective controlled study on the incidence of migraine in centro-temporal epilepsy compared to absence epilepsy, partial epilepsy and a group of patients with cranial trauma without epilepsy. The following observations from this series of 129 patients were made. Migraine was present in 63% of the patients with centro-temporal epilepsy (rolandic epilepsy), in 33% with absence epilepsy, in 7% with partial epilepsy and in 9% of the cranial trauma group. These results suggest that the association of centro-temporal epilepsy and migraine is non-fortuitous and also to a lesser degree in absence epilepsy. The role of neurotransmitters in this association is discussed. No decrease in cerebral blood flow was observed in 12 patients with rolandic epilepsy on a Hm-PAO SPECT study.

Adolescent↗
PubMed2001

Parents' perceptions of adversity introduced by upheaval and uncertainty at the onset of childhood epilepsy.

PURPOSE: We report the parent's perceptions of and reactions to the onset of "epilepsy only" and the implications for continuity of parenting. METHODS: Content analysis was used to extract data on perceived (dis)continuity of parenting, from interviews held with parents of 69 schoolchildren in whom idiopathic or cryptogenic epilepsy ("epilepsy only") had recently been diagnosed. RESULTS: Almost half of the parents (42%) perceived neither themselves nor their child as having been thrown off balance by the onset of epilepsy. Quite a few parents (33%) perceived themselves rather than their child as having been thrown off balance. More parents of children with cryptogenic than with idiopathic epilepsy perceived themselves as being off balance. However, parents' perceptions of their children's reactions to the epilepsy-related changes were not influenced by any epilepsy variable. Rather, family trouble, long-standing behavioral problems, and adolescence contributed to the child's maladaptive reaction. Three extremely off-balance parents had children with seizures of "unclassifiable" epilepsy that later were found to be nonepileptic and psychogenic. CONCLUSIONS: The majority of the parents perceived their child as adapting well to the onset of epilepsy only. Children with seizure onset in adolescence and children with other adversities were perceived as adapting poorly to the additional adversity of epilepsy. Cryptogenic rather than idiopathic etiology leaves parents in great suspense. In behavioral studies, it is advisable to treat children with unclassifiable epilepsy as a separate group.

Adolescent↗
PubMedDate not supplied

Seizure risk in offspring of parents with generalized versus partial epilepsy.

Genetic factors are commonly assumed to play a more important role in generalized than in partial epilepsy. This study tested this hypothesis by comparing risks of unprovoked seizures in offspring of individuals with generalized versus partial epilepsy. Overall, seizure incidence was no higher in offspring of persons with generalized epilepsy than in offspring of those with partial epilepsy. The number of affected offspring was about three times that expected from population incidence rates, regardless of whether the parent had partial or generalized epilepsy. For the subgroup of generalized cases with absence seizures, however, seizure incidence in offspring was about three times as high as for partial cases. The higher incidence in offspring of absence cases was only partly explained by a higher proportion of absence than partial cases with two factors associated with high risk in relatives, namely early age at onset and idiopathic epilepsy. Offspring of absence cases had higher risk than offspring of other cases not only for absence seizures, but for other seizure types as well, suggesting that absence epilepsy is not genetically distinct from other seizure types of epilepsy. These results suggest that the higher incidence sometimes observed in relatives of patients with generalized epilepsy is due to a small proportion of generalized cases with extremely high familial risks--most generalized epilepsies are no more likely than partial epilepsies to have a genetic basis.

Epilepsies, Partial↗