title: Complete remission in nonsyndromic childhood-onset epilepsy.
abstract: OBJECTIVE
  Determine the probability of attaining complete remission in children with nonsyndromic epilepsy (NSE) over the course of ≥10 years from initial diagnosis; identify early predictors of complete remission; and assess the risk of relapse after achieving complete remission.
  
  
  METHODS
  In a prospective community-based cohort, complete remission was defined as 5 years seizure-free and medication-free. Any subsequent seizure for any reason was a relapse. Univariate and bivariate analyses were conducted with standard methods including the Kaplan-Meier approach. Proportional hazards modeling was used for multivariable analysis.
  
  
  RESULTS
  Of 613 cohort members, 347 had NSEs, of whom 294 (85%) were followed ≥10 years (maximum = 17.9). A total of 170 in 294 (58%) achieved complete remission, 10 of whom (6%) relapsed. Seizure outcome at 2 years (remission, pharmacoresistant, unclear) (p < 0.0001) and underlying cause (p < 0.0001) distinguished groups with complete remission ranging from ~20% to ~75%. Older age at onset was independently associated with a poorer chance of complete remission. Relapses occurred up to 7.5 years after attaining complete remission and were marginally associated with underlying cause (p = 0.06).
  
  
  CONCLUSIONS
  Complete remission occurs in over one-half of young people with NSE and generally persists. Meaningful but imperfect predication is possible based on underlying cause and early seizure control. The finding of age effects may play a role in meaningful identification of phenotypes, which could become fruitful targets for genetic and imaging investigations in these otherwise poorly differentiated epilepsies.
authors.affiliation: Epilepsy Center, Children's Memorial Hospital, Northwestern University, Chicago, IL, USA. atberg@childrensmemorial.org
authors.forename: Anne T
authors.initials: AT
authors.lastname: Berg
authors.forename: Francine M
authors.initials: FM
authors.lastname: Testa
authors.forename: Susan R
authors.initials: SR
authors.lastname: Levy
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012074:Remission Induction; D012307:Risk Factors; D055502:Secondary Prevention
chemical_list: D000927:Anticonvulsants