PREDICTORS OF THE COURSE OF ILLNESS IN PATIENTS WITH CRYPTOGENIC FOCAL EPILEPSY WITH COMPLEX PARTIAL SEIZURES

The goal of the present study was to determine the features of cryptog enic focal epilepsy with complex partial seizures (CPS) that are predi ctive of the course of the illness. We undertook a long-term examinati on of 63 patients with cryptogenic and 20 with symptomatic epilepsy wi th CPS. Factors associated with a good prognosis were immediate initia l response to medical treatment with carbamazepine (CBZ) or phenytoin (PHT) with an initial seizure-free period >23 months, the occurrence o f an aura, stereotypic automatisms in combination with an aura, not mo re than nine grand mal seizures before initiation of sufficient antiep ileptic drug (AED) therapy, the regression of unilateral temporal slow wave foci and/or focal epileptogenic patterns in the EEG during AED t herapy, I.Q. >102.6, and absence of psychosyndromes and personality di sturbances. Negative prognosticators were the occurrence of complex au tomatisms, initial grand mal, bilateral temporal slow wave foci in the initial EEG, development of bilateral temporal slow wave foci during medical treatment, no regression of uni- or bilateral temporal epilept ic activity during treatment, I.Q. <91, and occurrence of moderate psy chosyndromes and/or personality disturbances. After 2 years, from the attained parameters, one can assess in most patients whether the progr ess of epilepsy is benign or whether pharmacoresistance must be assume d.