Limitations in the medical treatment of cryptogenic or symptomatic localization-related epilepsies of childhood onset.
We retrospectively examined 169 patients who had cryptogenic or symptomatic localization-related epilepsies (LRE) and were followed-up for more than 5 years. The probability of seizure control was 0.13 during the first year of treatment, 0.25 during the first 5 years, and 0.09 during the second and third 5 years. No patients who continued to have intractable seizures for 15 years became free of seizures. The onset of LRE at the age of 3 years or less, seizure cluster, mesial temporal sclerosis (MTS), and temporal lobe epilepsy (TLE) were significantly associated with a poor seizure control. If an antiepileptic drug (AED) failed to control seizures, probability of seizure control by the next drug was low, in particular in patients in whom more than 4 AEDs have already been tried, and seizure control could not be expected after a trial of 6 AEDs. A tentative indication of epilepsy surgery for LRE of childhood onset may be 5 years of poor seizure control and/or failure of four AEDs.
Aso
K
K
Department of Pediatrics, Aichi Prefecture Medical Welfare Center of Aoitori Gakuen. kaso@muc.biglobe.ne.jp
Watanabe
K
K
D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011379:Prognosis; D016896:Treatment Outcome