Long-term sequelae of epilepsy.
The long-term prognosis for epileptics vary from an entirely normal life to early death or complete incapacity. Studies to date have not provided clear answers on the long-term sequelae of epilepsy. This is because there are many epileptic syndromes with different outcomes. Most studies include a heterogeneous group of patients who may not be representative of all the epileptics in the community. The prognosis for permanent remission of seizure varies with the seizure type. In childhood epilepsies, overall there is at least 50% chance of permanent remission. The more seizures the patient has had before anticonvulsants were started, the more difficult it is to control the seizures, the poorer the prospects for remission. Other unfavourable signs include partial seizures, multiple seizure types, mental retardation, neurological deficits and underlying brain lesion. The effect of seizures on intellectual development is controversial. Actual regression in children with epilepsy is rare except where the seizures are caused by a progressive pathology. However, in a significant proportion of children, intellectual development slows down after the onset of seizures. This is more likely to occur in children with severe seizures, and those on multiple anticonvulsants and with frequent toxic levels. Children with epilepsy have an increased likelihood of developing behavioural, emotional and psychiatric problems. The underlying neurological dysfunction, anxiety about losing control of oneself at any time, reaction of parents, friends and teachers to the condition and side effects of anticonvulsants all contribute to the psychopathology. In conclusion, the long-term sequelae of epilepsy are multiple and serious. Some of the causal factors are known and preventable.(ABSTRACT TRUNCATED AT 250 WORDS)
Lee
W L
WL
Department of Neurology, Tan Tock Seng Hospital, Singapore.
D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology*; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology*; D004827:Epilepsy / Q000150:complications* / Q000523:psychology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007360:Intelligence; D019964:Mood Disorders / Q000209:etiology*; D011379:Prognosis