Clinical course of untreated tonic-clonic seizures in childhood: prospective, hospital based study

Donselaar, Cees A. van; Brouwer, Oebele F.; Geerts, Ada T.; Arts, W. F. M.; Stroink, Hans; Peters, A. C. B.

doi:10.1136/bmj.314.7078.401

Cited by 28 publications

(21 citation statements)

References 13 publications

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“…In a study by Zielinski (15) on``epileptics not in treatment'' it was demonstrated that only one quarter of patients with mild epilepsy (e.g., epilepsy with low seizure frequency) had consulted a physician. In a study by van Donselaar et al (12) a decelerating pattern of seizure occurrence was found in 83 of 85 children suffering from GTCS who became free of seizures without treatment. Thus, the number of patients suffering from epilepsy with GTCS might be underestimated (or misdiagnosed as syncope or reactive syndrome) (16,17).…”

Section: Discussionmentioning

confidence: 93%

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Precipitating factors and therapeutic outcome in epilepsy with generalizedtonic-clonic seizures

Bauer

Saher

Burr

et al. 2000

Acta Neurologica Scandinavica

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Section: Discussionmentioning

confidence: 93%

“…There are only a few reports on epilepsy with the sole manifestation of GTCS (12,13). Some of these patients suffered initially from generalized epilepsy with minor seizures and GTCS (14).…”

Section: Discussionmentioning

confidence: 99%

Precipitating factors and therapeutic outcome in epilepsy with generalizedtonic-clonic seizures

Bauer

Saher

Burr

et al. 2000

Acta Neurologica Scandinavica

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“…Studies by Camfield et al, Stroink et al, and Shinnar et al reported recurrence rates after the first seizure at 52%, 54%, and 37% by 2 years. 4 Seizure type does seem to play a role in whether the patient will have a recurrence. The studies by Stroink et al and Shinnar et al were prospective studies.…”

mentioning

confidence: 99%

“…The pressing question is to decide which patient will be most likely to have a recurrence of his or her seizure and to weigh this risk versus those of the use of antiepileptic medications. 3,4 van Donselaar et al noted that there was a trend toward longer intervals between seizures whether or not the patient received treatment. [1][2][3] All of the studies included children who had unprovoked seizures.…”

mentioning

confidence: 99%

Antiepileptic Drug Selection in Pediatric Epilepsy

Crumrine

2002

J Child Neurol

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This review article presents information concerning treatment options for various pediatric epilepsy syndromes. The decisions made in the selection of antiepileptic drugs are deternined by a number of variables that include, but are exclusive of, risk of seizure recurrence, patient age, epilepsy syndrome, known drug reactions, and prognosis of the epilepsy syndrome. The review discusses issues pertinent to antiepileptic drug selection including simple pharmacokinetic principles, antiepileptic drug formulations, and information concerning clinical studies using some of the antiepileptic drugs. Information is provided concerning the issues of seizure recurrence. Suggested paradigms for antiepileptic drug selection for partial seizures are provided. A table of antiepileptic drug costs is provided for assistance in prescribing and advising families. Psychosocial issues pertinent to the treatment of children are discussed.

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“…All children had GTCSs, often with a normal EEG or an EEG with aspecific abnormalities. Examples of subgroups could be the syndrome with generalized seizures with and without fever (GEFS+) (20), or the group of children with only sporadic GTCSs with a benign course (21).…”

Section: Discussionmentioning

confidence: 99%

Nonsymptomatic Generalized Epilepsy in Children Younger than Six Years: Excellent Prognosis, but Classification Should Be Reconsidered after Follow‐up: The Dutch Study of Epilepsy in Childhood

Middeldorp¹,

Geerts²,

Brouwer³

et al. 2002

Epilepsia

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Summary:Purpose: To assess the prognosis and the accuracy of the epilepsy classification in young children with nonsymptomatic generalized epilepsy.Methods: Of the cohort of the Dutch Study of Epilepsy in Childhood (n ‫ס‬ 466), all children younger than 6 years with a diagnosis of idiopathic (IGE) or cryptogenic (CGE) generalized epilepsy either at intake (n ‫ס‬ 108) and/or after 2 years of follow-up (n ‫ס‬ 102) were included. The number of reclassifications after 2 years was determined, and the reasons for reclassification were analyzed. All children receiving a diagnosis of IGE or CGE at 2 years were followed up for 5 years to study their outcome in terms of terminal remission (TR). Data on their level of intellectual functioning were collected at the start of this analysis.Results: The epilepsy syndrome was reclassified in 17 children. In 14 of them, the seizure type also was reclassified, and in three, the course of the epilepsy determined the new epilepsy type. Two other children had a reclassification of their seizure types without a change of the epilepsy type. Many children were categorized as having IGE not otherwise specified. In all probability, this is a heterogeneous group, containing patients with various epilepsy syndromes, with generalized tonic-clonic seizures as a common hallmark. Of the 102 children with IGE or CGE at 2 years of follow-up, 75% had a TR of >6 months after 2 years, and 85% a TR of Ն1 year after 5 years.Conclusions: In a fair proportion of children with nonsymptomatic generalized epilepsy in this age group, it is not possible to classify firmly the epilepsy and/or the seizures immediately after the intake. Instead, they are reclassified during the course of the disease. This and the apparent heterogeneity of the category IGE not otherwise specified point to inherent drawbacks of the current International League Against Epilepsy (ILAE) classification of epilepsy and epileptic syndromes. The prognosis of IGE at this young age is generally excellent.

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Clinical course of untreated tonic-clonic seizures in childhood: prospective, hospital based study

Abstract: Objective: To assess decleration and acceleration in the disease process in the initial phase of epsilepsy in children with new onset tonic-clonic seizures.

Cited by 28 publications

References 13 publications

Precipitating factors and therapeutic outcome in epilepsy with generalizedtonic-clonic seizures

Precipitating factors and therapeutic outcome in epilepsy with generalizedtonic-clonic seizures

Antiepileptic Drug Selection in Pediatric Epilepsy

Nonsymptomatic Generalized Epilepsy in Children Younger than Six Years: Excellent Prognosis, but Classification Should Be Reconsidered after Follow‐up: The Dutch Study of Epilepsy in Childhood

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