Y. Ohtsuka et al., Predictors and underlying causes of medically intractable localization-related epilepsy in childhood, PED NEUROL, 24(3), 2001, pp. 209-213
The goal of this study is to clarify the prognostic factors in childhood lo
calization-related epilepsy in a tertiary medical center. Children (n = 113
) with symptomatic and cryptogenic localization-related epilepsy were divid
ed into groups of intractable patients (average seizure frequency: one or m
ore per month during the 6 months before the last follow-up; n = 40) and we
ll-controlled patients (no seizures for at least 1 year before the last fol
low-up; n = 73), Clinical and electroencephalogram (EEG) factors were exami
ned to elucidate prognostic factors. The subtypes of epilepsies and causes
were also investigated. Univariate analyses indicated that the following fa
ctors were correlated with seizure outcome: (1) seizure type at the first v
isit; (2) seizure frequency; (3) underlying cause; (4) age at onset of epil
epsy; (5) status epilepticus occurring as the first seizure and before the
first visit; and (6) diffuse epileptic discharges on first visit interictal
EEGs, Multivariate analyses revealed that seizure type at the first visit,
seizure frequency, status epilepticus before the first visit, and underlyi
ng causes were significant independent predictive factors. The rate of intr
actable patients was highest in multilobar epilepsy, followed by frontal-lo
be epilepsy. Regarding etiologies, the intractable group contained nine pat
ients with encephalitis of unknown origin and three each with localized cor
tical malformation and mesial temporal sclerosis, (C) 2001 by Elsevier Scie
nce Inc. All rights reserved.