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PubMed2004

Features associated with epilepsy in the antiphospholipid syndrome.

OBJECTIVE: To assess the frequency of epilepsy in primary and secondary antiphospholipid syndrome (APS); to analyze the clinical and laboratory features characterizing those with epilepsy in a cohort of 538 patients with APS; and to find associated features that would suggest risk factors for epilepsy in APS. METHODS: We analyzed the clinical features of patients with APS who had epilepsy and compared them to the clinical features of non-epileptic APS patients. RESULTS: Of 538 APS patients, 46 (8.6%) had epilepsy. Epilepsy was more prevalent among APS secondary to systemic lupus erythematosus (SLE) compared to primary APS (13.7% vs 6%; p < 0.05). The patients with epilepsy had a higher prevalence of central nervous system (CNS) manifestations including focal ischemic events (strokes or transient ischemic events, 54.3% vs 24.6%; p < 0.0001) and amaurosis fugax (15.2% vs 4.9%; p < 0.05). APS patients with epilepsy had a higher frequency of valvular pathology (30.4% vs 14.6%; p < 0.01), thrombocytopenia (43.5% vs 25%; p < 0.05), and livedo reticularis (26.1% vs 11.5%; p < 0.01). The multivariate logistic regression analysis found CNS thromboembolic events as the most significant factor associated with epilepsy, with an odds ratio (OR) of 4.05 (95% confidence interval, CI: 2.05-8), followed by SLE (OR 1.4, 95% CI 1.2-4.7), and valvular vegetations (OR 2.87, 95% CI 1-8.27). CONCLUSION: Epilepsy is common in APS and most of the risk seems to be linked to vascular disease as manifested by extensive CNS involvement, valvulopathy, and livedo reticularis and to the presence of SLE. These factors, however, explain only part of the increased occurrence of epilepsy in APS and other causes such as direct immune interaction in the brain should be investigated.

Adult↗
PubMed2004

[Specific medico-social supports for drug-resistant partial epilepsies].

While employment appears to be among major concerns for epileptic patients, these are confronted with a very high rate of unemployment, especially when epilepsy is pharmacoresistant. However, the persistence of seizures is not the only factor bearing on vocational training or employment; other factors may intervene as well: cognitive dysfunctions, psychological/behavioral disturbances, impact of AEDs, education, vocational training, family members and relatives' attitude, school teams' attitude, employers' attitude, occupational physicians' attitude. Educational level is lower when epilepsy started at school-age; persisting seizures together with other problems may lead the epileptic child or teenager to attend specialized schools. In France, there are few institutions dedicated to children or teenagers with severe epilepsy, and these are very unevenly distributed over the French territory. The main social measures regarding children with epilepsy in France are mentioned. Besides being seizure-free and able to drive, work is one major expectation of patients from epilepsy surgery. The results of epilepsy surgery regarding employment are somewhat controversial; in some studies, temporal lobe surgery may not raise the employment rate; other studies point out that operated-on patients need a long time (up to 6 years) to find a job after surgery. The vocational level or the previous work experiences appear to be as important factors for further employment as being seizure-free, a condition which may not be met in all favourable work outcomes. The medico-social support to patients with pharmacoresistant partial epilepsies has to deal with all the factors mentioned previously; the opportunity for epilepsy surgery may have to be considered early in order to try and prevent the detrimental impact of pharmacoresistant epilepsy on school achievement and vocational training; adult patients with pharmacoresistant epilepsy often cumulate a low qualification level, an absence of a solid work experience, a lack of motivation and a social deprivation. Neurologists may have an insufficient knowledge of social and work regulations: in this paper we describe the main possibilities for epileptic patients to obtain social supports in France. Likewise, occupational physicians seldom know much about epilepsies. We have a positive experience of a multidisciplinary approach combining neurologists, occupational physicians and insertion teams. We are convinced that a personalized follow-up of the epileptic person is useful and often

Adolescent↗
PubMed2004

[International classification of epileptic seizures, epilepsies, and epileptic syndromes].

Epilepsy is one of the common diseases in neurology. Its correct diagnosis and classification are important for choosing the most appropriate treatment. Currently, Classification of Epileptic Seizures in 1981 and Classification of Epilepsies and Epileptic Syndromes in 1989, both were proposed by International League Against Epilepsy (ILAE), are available. As for Classification of Epilepsies and Epileptic Syndromes, two divisions continue to be widely used to shape the major classes: The first separates epilepsies with generalized seizures (generalized epilepsy) from epilepsies with partial or focal seizures (localization-related, partial or focal epilepsies). The other separates epilepsies of known etiology (symptomatic or secondary epilepsies) from those that are idiopathic (primary) and those that are cryptogenic. In 2001, ILAE Task Force proposed a new classification. However, its daily use has yet been limited. Simple and useful classification will lead to better understanding and more appropriate management of epilepsy.

Epilepsy↗
PubMed1979

[Epidemiological investigation on epilepsy in children of school age (author's transl)].

An epidemiological investigation was carried out in 1976-77 on all children attending the fourth year of primary education (9-10 years old) in Venice. The method of analysis was a questionnaire similar to that proposed by Rose (Epilepsy 1973) and by Meighan (Epilepsy 1976). Out of 1838, 1350 answered the questionnaire. The questionnaire synthesises various symptoms of epilepsy in 30 questions starting from the most severe ones. In a second phase the answers were divided into 8 groups: the hypothesis was that the percentage of children with epilepsy in groups 1-3 (high probability to have epilepsy) would be significantly higher than in groups 4-7. In order to test this hypothesis and to assess the discriminating quality of the questionnaire, a random sample of 114 children was submitted to clinical and EEG examination. The final classification in: A) epilepsy; B) febrile convulsions; C) minimal brain disfunction (M.B.D., according to Rose's definition); D) normal, was agreed upon including the heterogeneous information derived from history, neurological examination and EEG interpretation. A statistical elaboration of the findings has shown that the weighted average prevalence rate resulted to be 8.7%; the one relating to febrile convulsions was 27.93%; the one of M.B.D. was 5.2%. The high incidence of apparently positive cases may be explained because of difficulty in understanding some of the terminology used in the questionnaire; such cases, however, have been identified and discarded after a fuller history and neurological examination had been obtained. The problem of false negative cases seems however more important since it may also be caused by prejudice and by the reluctance of many people to accept the idea of epilepsy. For the appraisal of the incidence of this phenomenon we have examined all children (about 90) in two schools of the city indipendently from the answers in the questionnaire: no case of epilepsy was found. Further investigation is being carried out through an inquiry in EEG laboratories, hospitals and private phisicians in order to find out the real number of epileptic children. The incidence of epilepsy estimated with other methods appears similar to our data (Cooper 1965 - Huser and Kurland 1975). As a conclusion the questionnaire survey approach can be effectively used in studies on epilepsy together with epidemiological investigations in the assessment of cases of epilepsy not yet diagnosed as such.

Age Factors↗
PubMed1996

[Treatment of epilepsy: where are we today?].

The modern treatment of epilepsy has improved considerably in all three pillars. More than a century has passed, however, since Sir Charles Locock introduced the bromides in 1857 and Sir Victor Horsely pioneered epilepsy surgery in 1886 (18). In drug therapy, the 'classic AED' of the last decades, i.e. phenobarbital (Hauptmann, 1912) and phenytoin (Putnam and Merrit, 1938) are being largely displaced by valproate (Meunir, 1963) and carbamazepine (Lorge, 1963). Only ethosuximide (Zimmermann, 1951) has continued to maintain its position in 3/s spikewave-absence epilepsy, in particular in the USA (28, 29). Although it is an excellent drug against absences, it has the unpleasant property that it may induce GM seizures and should therefore be combined with a so-called 'GM protector' (mostly phenobarbital). For this reason ethosuximide has been relegated to second place in Europe by valproate. Thus, the decision as to which AED should be employed at the outset has been simplified considerably: actually, with valproate as the drug of first choice, which displays a very broad spectrum of action, we are on the right track for virtually all forms of epilepsy, perhaps with the exception of focal epilepsy (11). Especially in the event of focal epilepsy of temporal origin we employ carbamazepine as the preparation of first choice. In some countries (Denmark), because of the less severe side effects, oxcarbazepine is already preferred (Mogens Dam, personal communication). Considerable experience and knowledge are still required, however, when resistance has developed to traditionally applied classic monotherapy. Here, the range of further treatment can also be greatly extended by the availability of the 'new AED'. A generally accepted protocol for the replacement of one preparation with another first- or second-choice drug and, above all, for the 'right' combination with third-choice preparations can as yet not be compiled. What we need here is the expert epileptologist who has experience with 'theoretically useful' combinations and has an insight into the interactions occurring with such combinations. For several specific epileptic syndromes the 'Königsteiner Working Group of German-Speaking Epileptologists' has given clear and binding recommendations for AED therapy (e.g. for benign juvenile myoclonic epilepsy--Janz syndrome). This working group has also made recommendations for the necessary clinical and laboratory controls in AED therapy with potentially severe side effects (e.g. valproate therapy in high-risk children), which were published and/or are being published and discussed in the 'Epilepsie-Blätter' of the German League against Epilepsy (4). Despite all advances in drug therapy, the number of epilepsy patients not satisfactorily treatable with drug therapy has not been dramatically reduced statistically, so that the other two pillars of epilepsy therapy, i.e. epileptic surgery and behavioural therapy, continue to be very important.

Anticonvulsants↗
PubMed1996

A general practice records audit of the process of care for people with epilepsy.

BACKGROUND: The appropriateness of epilepsy as a topic for general practice audit activity has been emphasized, but few audits have been undertaken to data and those that have are small scale. Historically, management of epilepsy has been a neglected area, and services for people with epilepsy remain generally poor. AIM: The study was designed to examine the process of care for people with epilepsy through a region-wide audit of general practitioner records. METHOD: General practitioners in 31 randomly selected general practices in one UK health region undertook a notes audit for all patients identified as having active epilepsy (patients who had had seizures in the last 2 years, or were currently seizure-free but on antiepileptic medication). A standard pro forma was used to collect information relating to diagnosis, drug treatment, and primary and secondary care contacts. RESULTS: Recording of information in the notes was generally good, but poor for some key items essential to the effective management of the condition; results suggest that a number of recommendations about provision of care for epilepsy are not being met: in particular, EEG and CT investigations often appear poorly directed; prescribed antiepileptic therapy is not always optimal; significant numbers of patients are being treated in hospital by non-neurologists; there is little evidence of any regular review being undertaken by general practitioners of their patients with epilepsy; and counselling about the non-clinical aspects of epilepsy often appears inadequate. CONCLUSIONS: Despite recommendations in a number of recent reports, gaps and inconsistencies in epilepsy care persist, both at the primary and secondary level. The means by which such shortcomings can be reduced (e.g. by specialist epilepsy nurses working across the primary-secondary care interface) should now be systematically examined. The study has highlighted a need for evidence-based guidelines which span the primary-secondary care interface and clarify the contribution of the various practitioners involved in the provision of care for people with epilepsy.

Adolescent↗
PubMed2000

Impact of our understanding of the genetic aetiology of epilepsy.

A genetic contribution to aetiology is estimated to be present in up to 40% of patients with epilepsy. It is useful to categorise genetic epilepsies according to the mechanisms of inheritance into Mendelian disorders, non-mendelian or 'complex' disorders, and chromosomal disorders. Over 200 Mendelian diseases include epilepsy as part of the phenotype, and the genes for a number of these have been identified recently. These include autosomal recessive progressive myoclonic epilepsies such as Unverricht-Lundborg disease, Lafora disease and the neuronal ceroid lipofuscinoses, and three autosomal dominant idiopathic epilepsies. The last named have been shown to arise from mutations in ion channel genes. Autosomal dominant nocturnal frontal lobe epilepsy is caused by mutations in CHRNA4, benign familial neonatal convulsions by mutations in KCNQ2 and KCNQ3, and generalised epilepsy with febrile seizures plus by mutations in SCN1B. 'Complex', familial epilepsies are more difficult to analyse, but evidence has been obtained for loci predisposing to juvenile myoclonic epilepsy on chromosome 6p and 15q. Lastly, the genes underlying several spike-wave epilepsies in mice have been cloned, and three of these encode sub-units of voltage-gated calcium channels.

Animals↗
PubMed1996

The I.L.A.E. classification of the epilepsies applied retrospectively to 1902 patients.

The I.L.A.E. classification of the epilepsies and epileptic syndromes was applied retrospectively to the epileptic seizure disorders of 1902 consecutive patients collected from a neurological consultant practice over a 30 year period. There were 265 patients with only a solitary seizure when they presented. These 265 included fewer instances of generalized epilepsies (14.0% versus 28.5%) and more instances of epilepsies of undetermined type (35.1% versus 20.4%) than the remaining 1637 patients. It was possible to categorize the epilepsy or epileptic syndrome present in 77.6% of all cases. The remainder could not be classified on the evidence available and thus fell into the I.L.A.E. classification's category of "epilepsies and syndromes undetermined whether focal or generalized'. The number of cases of such epilepsy of undetermined type decreased with increasing number of occasions on which patients were seen. Allowing for the effects of factors such as different age distributions in the various published series (in most series generalized epilepsies were more common in children), the distribution of epilepsies and epileptic syndromes diagnosed retrospectively in the present series was quite consonant with the data reported in the literature from contemporaneous series. In the various published series there were notable differences in the proportions of subjects allocated to the category of 'epilepsies and syndromes undetermined whether focal or generalized'. This raises the possibility that the categorizers' degrees of diagnostic confidence may have had appreciable effects on the reported distributions of epileptic syndromes in the different series. Some consensus regarding the degree of diagnostic probability acceptable for assigning a patient to a particular epileptic syndrome might yield more uniform outcomes from future epilepsy classificational attempts.

Adolescent↗
PubMed2001

Two-year remission and subsequent relapse in children with newly diagnosed epilepsy.

PURPOSE: Although remission is the ultimate measure of seizure control in epilepsy, and epilepsy syndrome should largely determine this outcome, little is known about the relative importance of syndrome versus other factors traditionally examined as predictors of remission or of relapse after remission. The purpose of this study was to examine remission and relapse with respect to the epilepsy syndrome and other factors traditionally considered with respect to seizure outcome. METHODS: A prospectively identified cohort of 613 children with newly diagnosed epilepsy was assembled and is actively being followed to determine seizure outcomes. Epilepsy syndrome and etiology were classified at diagnosis and again 2 years later. Remission was defined as 2 years completely seizure-free, and relapse as the recurrence of seizures after remission. Multivariable analysis was performed with the Cox proportional hazards model. RESULTS: Five hundred ninety-four of the original 613 children were followed > or = 2 years (median follow-up, 5 years). Remission occurred in 442 (74%), of whom 107 (24%) relapsed. On multivariable analysis, idiopathic generalized syndromes and age at onset between 5 and 9 years were associated with a substantially increased remission rate, whereas remote symptomatic etiology, family history of epilepsy, seizure frequency, and slowing on the initial EEG were associated with a decreased likelihood of attaining remission. Young onset age (<1 year) and seizure type were not important after adjustment for these predictors. Relapses occurred more often in association with focal slowing on the initial EEG and with juvenile myoclonic epilepsy. Benign rolandic epilepsy and age at onset <1 year were associated with markedly lower risks of relapse. About one fourth of relapses were apparently spontaneous while the child was taking medication with good compliance, and more than half occurred in children who were tapering or had fully stopped medication. CONCLUSIONS: A large proportion of children with epilepsy remit. Symptomatic etiology, family history, EEG slowing, and initial seizure frequency negatively influence, and age 5-9 years and idiopathic generalized epilepsy positively influence the probability of entering remission. Factors that most influence relapse tend to be different from those that influence remission.

Age Factors↗
PubMed1977

Profile of epilepsy in a developing country: a study of 1,000 patients based on the international classification.

The present prospective study undertaken in a specialized neurological center of a developing country deals with 1,000 epileptic patients classified in accordance with the International Classification. Eighty-one percent of the patients could be classified, with a lower incidence in the younger age group. Partial epilepsy was found to be far more common than generalized epilepsy (80% versus 20%). Primary generalized epilepsy was seen in 15% and secondary generalized in 5%. Partial epilepsy with elementary symptomatology was seen in 58% and complex symptomatology in 7%. Secondarily generalized seizures were seen in the remaining 15%. Primary generalized epilepsy and partial epilepsy with complex symptomatology were more common in adults. Secondary generalized epilepsy and partial epilepsy with secondarily generalized seizures were more common in children. Partial epilepsy with elementary symptomatology, however, did not vary significantly with age. The higher incidence of partial epilepsy in our patients, compared to the West, could be due to greater frequency of CNS infections and birth injuries, which are common childhood hazards in the developing countries.

Adult↗
PubMed1989

[Epilepsy with rolandic paroxysms and migraine, a non-fortuitous association. Results of a controlled study].

The incidence of migraine was studied in 4 groups of patients: patients with centro-temporal epilepsy, patients with absence of epilepsy, patients with partial epilepsy, and non-epileptic patients with a history of cranial trauma. Migraines were present in 62% of the patients with centro-temporal epilepsy, 34% of the patients with absence of epilepsy, 8% of the patients with partial epilepsy and 6% of the patients with cranial trauma. These results suggest that the association of centro-temporal epilepsy and migraine is non-fortuitous as well as, to a lesser degree, absence of epilepsy and migraine. The authors discuss the role of serotonin in the association epilepsy-migraine and suggest that centro-temporal epilepsy might be a feature for the diagnosis of migraine.

Adolescent↗
PubMed1987

[Effect of cerebral organic changes on the age of manifestation of childhood epilepsy].

In the present study, the influence of organic alterations in the brain on the age of manifestation of epilepsy was investigated by means of cranial computer tomography (CCT) in 307 children and adolescents. 38% of these patients revealed abnormal morphological findings in the CCT. Whereas in children with primary generalized and partial epilepsy the vast majority (80% and 75% respectively) showed normal findings, this only applied to barely half of the patients with secondary generalized epilepsy. The pathological CCT findings were characterized mainly by diffuse alterations in primary generalized epilepsy. On the other hand, children with secondary generalized epilepsy showed above-average focal defects. The age of onset of the disease showed a close relation with the CCT findings. In patients with pathological CCT alterations, the epilepsy was manifested very much earlier than in the reference group. However, the special features of the age distribution in relation to the CCT findings only applied to secondary generalized epilepsy. Thus 80% of the diseases in the first year of life involved this form of epilepsy (in the vast majority, West syndrome), in which pathological CCT alterations were present almost without exception. These results made it evident that exogenous factors have a crucial effect on the age of manifestation, the clinical features and course of epilepsy.

Adolescent↗
PubMed2003

A retrospective analysis of patients with febrile seizures followed by epilepsy.

This study was performed to investigate some clinical parameters of febrile seizures (FSs) in patients with epilepsy, testing any possible correlation between those parameters and the type of subsequent epilepsy. One hundred and nine patients with epilepsy having a history of FSs were evaluated for age at onset of FSs, interval between first FS and first afebrile seizure, recurrence rate, type of FSs, incidence of febrile status, family history for epilepsy and for FSs and the neurological status of the patient. The epilepsy that developed subsequently, were classified as generalised versus partial and also according to their syndromic subgroups. In temporal lobe epilepsy with mesial temporal sclerosis (TLE-MTS), statistical analyses revealed a younger age at onset of FSs, and a high incidence of episodes of febrile status and of complex FSs. Clinical characteristics of FSs followed by partial epilepsies were younger age at onset, presence of focal features and of febrile status, longer interval between the first FS and the first afebrile seizure, and a high incidence of FSs in the family history. In generalised epilepsies, however, a shorter interval between the first FS and the first afebrile seizure, a high incidence of single FS and of a family history of epilepsy were predominating characteristics. Results suggest that certain features of FSs may be predictive of a particular type of subsequent epilepsy.

Adolescent↗
PubMed2002

Attention deficits are not characteristic of schoolchildren with newly diagnosed idiopathic or cryptogenic epilepsy.

PURPOSE: To compare problems of attention in schoolchildren with newly diagnosed idiopathic or cryptogenic epilepsy with those in healthy classmates. METHODS: A computerized battery of tasks comprised Reaction Time (RT) measurement, Trail making (Color Trails 1 and 2), Manual Tapping and Steadiness, and a newly developed task of sustained attention (Balloon Piercing). SUBJECTS: Fifty-one children with epilepsy (age 7-16 years) and 48 gender- and age-matched classmates were assessed thrice: within 48 h after diagnosis [before start of antiepileptic drugs (AEDs)], and 3 and 12 months later. Significantly more children with epilepsy (51%) than control children (27%) had required special educational assistance at school. RESULTS: Children with epilepsy could not be distinguished from controls in execution times or motor speed. However, errors were more frequent among patients in a "go-no-go" RT task, and errors of omission in a task requiring sustained attention. Within the group of children with epilepsy, those with prior school or behavior difficulties and those whose parents reacted maladaptively to the onset and diagnosis of epilepsy performed worse than those without these adversities, in the sense that their RT increased inordinately with increasing task difficulty. Epilepsy-related variables did not explain any variance. Transient inordinately poor performances were found in 69% of patients and 40% of controls. CONCLUSIONS: Children with newly diagnosed "epilepsy only" do not have persistent attention deficits. AED treatment has no detrimental effect on attention. Prior school and behavior difficulties and a maladaptive reaction to the onset of epilepsy rather than epilepsy variables are related to decreased attentional efficiency.

Attention↗
PubMed1997

Generalized epilepsy with febrile seizures plus. A genetic disorder with heterogeneous clinical phenotypes.

The clinical and genetic relationships of febrile seizures and the generalized epilepsies are poorly understood. We ascertained a family with genealogical information in 2000 individuals where there was an unusual concentration of individuals with febrile seizures and generalized epilepsy in one part of the pedigree. We first clarified complex consanguineous relationships in earlier generations and then systematically studied the epilepsy phenotypes in affected individuals. In one branch (core family) 25 individuals over four generations were affected. The commonest phenotype, denoted as 'febrile seizures plus' (FS+), comprised childhood onset (median 1 year) of multiple febrile seizures, but unlike the typical febrile convulsion syndrome, attacks with fever continued beyond 6 years, or afebrile seizures occurred. Seizures usually ceased by mid childhood (median 11 years). Other phenotypes included FS+ and absences, FS+ and myoclonic seizures, FS+ and atonic seizures, and the most severely affected individual had myoclonic-astatic epilepsy (MAE). The pattern of inheritance was autosomal dominant. The large variation in generalized epilepsy phenotypes was not explained by acquired factors. Analysis of this large family and critical review of the literature led to the concept of a genetic epilepsy syndrome termed generalized epilepsy with febrile seizures plus (GEFS+). GEFS+ has a spectrum of phenotypes including febrile seizures, FS+ and the less common MAE. Recognition of GEFS+ explains the epilepsy phenotypes of previously poorly understood benign childhood generalized epilepsies. In individual patients the inherited nature of GEFS+ may be overlooked. Molecular genetic study of such large families should allow identification of genes relevant to febrile seizures and generalized epilepsies.

Adolescent↗
PubMed2003

Sleep epilepsy.

BACKGROUND: Seizures during sleep have been recognized for centuries, and it is well known that both sleep and lack of sleep can influence the occurrence of ictal and interictal events. Sleep epilepsy refers to the subset of epilepsy in which seizures occur exclusively or predominantly during sleep. Primary generalized, secondarily generalized, and focal partial epilepsy syndromes can all manifest as sleep epilepsy. The spread of polysomnography has increased our ability to accurately diagnose sleep epilepsy and facilitated the discovery of an autosomal dominant sleep epilepsy. REVIEW SUMMARY: This review summarizes the epidemiology of sleep epilepsy and reviews a number of epilepsies that can manifest as sleep epilepsy as well as some nonepileptic sleep disorders from which sleep epilepsy must be differentiated.

Diagnosis, Differential↗
PubMed2004

Increased prevalence of epilepsy associated with severe falciparum malaria in children.

PURPOSE: Multiple, prolonged, generalized, or focal seizures are common in children with severe malaria, with or without coma. In other contexts, such seizures have been associated with the development of epilepsy. The relation between falciparum malaria and epilepsy is undetermined; thus we measured the prevalence and characteristics of epilepsy in children with a history of severe malaria. METHODS: We took a detailed epilepsy history from the parents of 487 children (aged 6-9 years) to compare the prevalence of epilepsy between three exposure groups: children with a history of cerebral malaria (CM), malaria and complicated seizures (M/S), or those unexposed to either complication. Each child had an EEG and was classified as having active, inactive, or no epilepsy. RESULTS: An increased prevalence of epilepsy was seen in children previously admitted with CM [9.2%; OR, 4.4; 95% confidence interval (CI), 1.4-13.7] or M/S (11.5%; OR, 6.1; 95% CI, 2.0-18.3) compared with the unexposed group (2.2%). The most commonly reported seizure types were tonic-clonic (42%), focal becoming secondarily generalized (16%), and both (21%). Twenty-six percent of the active epilepsy group initially had EEG abnormalities. CONCLUSIONS: These results suggest that children exposed to CM or M/S have an increased propensity for epilepsy relative to children unexposed to these complications. The prevalence of epilepsy associated with CM is similar to that reported after other severe encephalopathies. The prevalence associated with M/S is more than twice that reported after complicated febrile seizures.

Child↗
PubMedDate not supplied

Memory function in childhood epilepsy syndromes.

OBJECTIVE: Children with epilepsy are at risk of specific cognitive deficits. We aimed to compare and characterize the memory function of children with childhood absence epilepsy (CAE), frontal lobe epilepsy (FLE) and temporal lobe epilepsy (TLE). METHODS: Epilepsy syndrome was identified by clinical data, seizure semiology, interictal and ictal electroencephalogram (EEG). Seventy children aged 6-18 years with CAE, FLE or TLE had neuropsychological assessment including memory function. After adjusting for epilepsy variables, neuropsychological results of the syndrome groups and normative data were compared. RESULTS: Children from all three syndrome groups were at risk of memory difficulties. The duration of epilepsy correlated negatively with memory function. Children with TLE had the worst memory function, significantly lower in verbal memory tasks than children with CAE (P = 0.02) and children with FLE (P = 0.01). The performance of children with TLE was significantly below the normed mean across all verbal and most visual tasks. Compared to the normed means, children with FLE had results that were statistically lower in some verbal and visual tasks, and children with CAE were lower in two visual tasks only. CONCLUSIONS: This study demonstrates memory dysfunction in three common childhood epilepsy syndromes. Children with TLE had the greatest impairment, children with FLE had memory difficulties not previously reported, and children with CAE had subtle memory deficits. Qualitative differences were also evident. Longer duration of intractable epilepsy was associated with reduced memory ability. Memory function and its potential impact on academic achievement are vital considerations when managing children with epilepsy.

Adolescent↗