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KMID : 0877219970010010112
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Journal of Korean Epilepsy Society
1997 Volume.1 No. 1 p.112 ~ p.118
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Epilepsy in the First Year of life : Etiologic Factors and Outcome
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Kim Jong-Shin
Kim Won-Seop
Kim Hyun-Mi
Cho Kang-Ho
Kim Ki-Joong
Park Ho-Jin
Hwang Yong-Seung
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Abstract
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Purpose : Epilepsy occurring in infancy constitutes a heterogeneous group. A high proportion of the epilepsies that begin within the first year of life, do not belong to recognized epileptic syndromes, and these haute been relatively rarely studied. So we studied the etiologic factors and prognosis according to seizure types.
Method : We evaluated 74 infants with seizures developed between 1 and 12 months of age who were diagnosed at the children’s hospital of Seoul National University from January 1988 to December 1992 and followed up for more than 3 years. All cases were divided into Infantile spasm (24 cases), generalized (37 cases) and partial (13 cases) seizure on the basis of the ictal clinical findings. Etiologic factor and prognosis were analyzed according to seizure types. Differences were considered statistically significant for p-values of 0.05 or less.
Results : 1) Incidences of pre-or perinatal abnormality CNS structural abnormality and family history of febrile convulsion or epilepsy were not significantly different in the each types. 2) In the comparison of developmental state, between at diagnosis and at the last follow-up theses were significantly different in infantile spasm, but not in the partial and generalized seizure. Difference of the neurological outcome was not significant in all three groups. 3) At follow-up (manse 3-8.8 years mean : 5.7 years), 8 patients had died. The rate of seizure free were 76% (28/37). 62% (8/13) and 25% (6/24), complete recovery were 65% (24/37), 38% (2/13). and 13% (5/24) in generalized seizure. partial seizure and infantile spasm, respectively. 5) The comparison of the group with family history of febrile seizure or epilepsy and without family history seizure free and complete recovery rate were not significantly different between the two groups. 6) Seizure free and complete recovery rate were significantly better in idiopathic or cryptogenic group than symptomatic group. 7) In the group of first seizure had occurred under 6 months. seizure free, complete recovery and death rate were not significantly different compared with the group above 6 months.
Conclusion : In all three groups, factor associated with a poor prognosis was symptomatic nature of the epilepsy, whereas a family history of febrile convulsion or epilepsy and age of first attach were not associated with prognosis. Our result showed poor prognosis in the patients who had infantile spasm and partial seizure, especially in the symptomatic group. In these circumstance, epileptic surgery may be considered in the cases which ictal onset zone is localized.
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KEYWORD
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Epilepsy in infancy, Prognosis
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