Childhood-onset epilepsy five decades later : A prospective population-based cohort study

Matti Sillanpää, Anu Anttinen, Juha O. Rinne, Juho Joutsa, Pirkko Sonninen, Matti Erkinjuntti, Bruce Hermann, Mira Karrasch, Maiju Saarinen, Petri Tiitta, Shlomo Shinnar

Forskningsoutput: TidskriftsbidragArtikelVetenskapligPeer review

42 Citeringar (Scopus)

Sammanfattning

Objective

To study the impact of childhood-onset epilepsy on a variety of outcomes across the life span.

Methods

A population-based cohort of 245 subjects with childhood-onset epilepsy was assessed for outcomes at 45 years. In addition, 51 of 78 surviving subjects with uncomplicated epilepsy and 52 of 99 originally matched controls participated in a detailed evaluation including electroencephalography (EEG), imaging, and laboratory studies at 50 years.

Results

Of 179 surviving subjects, 61% were in terminal 10-year remission and 43% in remission off medications. At 45 years, 95% of the idiopathic group, 72% of the cryptogenic group, and 47% of the remote symptomatic group were in terminal remission (p < 0.001). Abnormal neurologic signs were significantly more common in subjects with uncomplicated epilepsy than in controls. Mortality during period 1992–2012 was higher in subjects than in controls (9% vs. 1%, p = 0.02). The rate of 3T MRI abnormalities was higher in subjects than in controls (risk ratio [RR] 2.0; 1.3–3.1) specifically including findings considered markers of cerebrovascular disease (RR 2.5; 1.04–5.9). Even subjects with idiopathic epilepsy had higher rates of imaging abnormalities than controls (73% vs. 34%, p = 0.002).

Significance

Long-term seizure outcomes are excellent and a function of etiology. The presence of imaging abnormalities suggestive of vascular disease may put these subjects at higher risk for clinically evident stroke and cognitive changes as they age.

OriginalspråkOdefinierat/okänt
Sidor (från-till)1774–1783
TidskriftEpilepsia
Volym56
Utgåva11
DOI
StatusPublicerad - 2015
MoE-publikationstypA1 Tidskriftsartikel-refererad

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