Biologic factors as predictors of social outcome of epilepsy in intellectually normal children: a population-based study.
We studied social outcome for all the normally intelligent children in our province with onset of epilepsy between 1977 and 1985 (excluding absence and "minor motor" seizures). After follow-up averaging 7 1/2 years, the 337 patients were 7 to 28 years of age. Outcome measures were age dependent. Of those old enough to be at risk, the percentage with each unfavorable outcome was as follows: school failure 34%, use of special educational resources 34%, mental health consultation 22%, psychotropic medication 5%, unemployment 20%, social isolation 27%, inadvertent pregnancy 12%, and criminal conviction 2%. In social isolation 27%, inadvertent pregnancy 12%, and criminal conviction 2%. In a multivariate model correcting for number of potential unfavorable outcomes (based on age at end of follow-up), many variables related to epilepsy, seizure control, and electroencephalographic findings were not associated with social outcome. Only two variables were associated with at least one unfavorable outcome--learning disorder (p < 0.001) and more than 21 seizures before treatment was begun (p < 0.03). The only variable with no unfavorable outcome was simple partial seizures (p < 0.003). Sensitivity and specificity of this model were 54% and 68%, respectively, indicating that social outcome for these children was often not related to biologic factors reflected by the medical details and clinical course of their disorder.
Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
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Camfield
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Camfield
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Smith
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Gordon
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Dooley
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003415:Crime; D004522:Educational Status; D004651:Employment; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007360:Intelligence; D007859:Learning Disabilities / Q000150:complications; D008297:Male; D001523:Mental Disorders / Q000150:complications; D012959:Socioeconomic Factors