10-year Outcome of Childhood Epilepsy in Well-functioning Children and Adolescents

Abstract: Introduction: Epilepsy is one of the most common neurologic disorders in children and young adults. The prognosis depends on various conditions but the long-term prognosis regarding seizure freedom is positive in the majority of the children. Individuals with childhood-onset epilepsy are reported to have more problems in social functioning and psychological well-being compared with healthy control. The aim of this study was to investigate 10-year outcome of medical, psychological and social outcome in well-functioning individuals with childhood-onset epilepsy. Methods: Forty-five individuals and their parents completed a questionnaire regarding family history of epilepsy, febrile seizures, primary, mental retardation and behaviour disorders; and patients history of actual seizure situation, antiepileptic drug medication, febrile seizures, behaviour disorders, primary headaches, and schooling (Study I). Two families denied participation. Out of the remaining 45 families, 31 filled in a questionnaire - Achenbach System of Empirically Based Assessment (ASEBA) - assessing competence, adaptive functioning and behavioural/emotional problems (Study II). Results: The overall remission was 75.6%. Of the 11 with active epilepsy five had cryptogenic/ unknown or structural/symptomatic focal epilepsy; one had idiopathic photosensitive occipital epilepsy, one each with the diagnoses childhood absence epilepsy and juvenile absence epilepsy, and three with other idiopathic generalized epilepsies. The family history of epilepsy was 44% and of febrile seizures 17.7%. A coincidence of focal and generalized epilepsy phenotypes was found in some families. Behavioral, emotional and school problems were found in 29%. Those with active epilepsy had significantly more attention problems and somatic complaints than those in remission. Two individuals presented several problems in the clinical range. Conclusion: Longitudinal studies are of importance in epilepsy epidemiology. Early intervention in children and adolescents with epilepsy is of importance as knowledge about the disorder and eventual additional co-morbidities decreases the risk of depression, social anxiety and low self-esteem in adulthood.