Document Detail


Cryptogenic localization related epilepsy in children from a tertiary outpatient clinic: is neurological and neuropsychological outcome predictable?
MedLine Citation:
PMID:  17451873     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Up to one-third of the children with epilepsy are diagnosed with cryptogenic localization related epilepsy (CLRE). As yet, there is a lack of studies that specify the short- and long-term prognosis for this group. In this study, we systematically established neurological outcome (represented by seizure frequency) as well as neuropsychological outcome in a cohort of 68 children with CLRE who had been referred to our tertiary outpatient clinic. Also, we analysed correlations with risk and prognostic factors. PATIENTS AND METHODS: A systematic cross-sectional open clinical and non-randomized design was used including 68 children admitted to our epilepsy centre in a child neurological programme between January 1999 and December 2004. A model was defined, distinguishing risk factors with a potential effect on epileptogenesis (history of febrile seizures, family history of epilepsy, history of early mild development delay and serious diagnostic delay) and prognostic factors, with a potential effect on the course of the epilepsy (neurological symptoms or soft signs, age at onset, duration of epilepsy, seizure type, percentage of time with epileptiform activity, localization of epileptiform activity, treatment history and treatment duration). Seizure frequency was used as the primary outcome variable, whereas three neuropsychological outcomes (IQ, psychomotor delay and educational delay) were used as secondary outcome variables. RESULTS: The children experienced a broad range of seizure types with the 'absence-like' complex partial seizure as the most commonly occurring seizure type. Almost half of the children of the study sample had a high seizure frequency. They experienced several seizures per month, week or even daily seizures. Also a substantial impact on neuropsychological outcome was observed. Mean full scale IQ was 87.7, mean academic delay was almost 1 school year and 27 children showed psychomotor delay on the Movement ABC. Only 'having more than one seizure type' showed a prognostic value for seizure frequency, and no factors were found to be correlated with the secondary outcome measures. None of the risk factors show a differential impact on seizure outcome. CONCLUSION: CLRE has a non-predictable course; clinical variability is high and prognosis in many children with CLRE is obscure. Having more than one seizure type was the only factor correlated to seizure frequency. Further longitudinal studies are needed.
Authors:
Rianne P Reijs; Saskia G M van Mil; Johan B A M Arends; Mariette H J A van Hall; Jacobiene W Weber; Willy O Renier; Albert P Aldenkamp
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Publication Detail:
Type:  Journal Article     Date:  2007-04-23
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  109     ISSN:  0303-8467     ISO Abbreviation:  Clin Neurol Neurosurg     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-04     Completed Date:  2007-08-17     Revised Date:  2009-10-14    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  422-30     Citation Subset:  IM    
Affiliation:
Department of Research and Development, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands. rreijs@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Cross-Sectional Studies
Developmental Disabilities / diagnosis,  epidemiology
Electroencephalography
Epilepsies, Partial / diagnosis*,  epidemiology
Epilepsy / diagnosis*,  epidemiology
Epilepsy, Complex Partial / diagnosis,  epidemiology
Female
Humans
Intelligence
Learning Disorders / diagnosis,  epidemiology
Male
Netherlands
Neurologic Examination*
Neuropsychological Tests*
Prognosis
Psychomotor Disorders / diagnosis,  epidemiology
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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