OUTCOME OF CHILDHOOD EPILEPSY - A POPULATION-BASED STUDY WITH A SIMPLE PREDICTIVE SCORING SYSTEM FOR THOSE TREATED WITH MEDICATION

A population-based study was conducted in on attempt to predict which child's epilepsy will remit. Use of data from a regional electroenceph alography laboratory allowed identification of all children in Novo Sc otia with epilepsy onset from 1977 through 1985 (excluding those with absence and ''minor motor'' seizures). Children were followed for an a verage of 7 years. On the basis of clinical characteristics, a multiva riate analysis was used to develop a scoring scheme to predict remissi on (defined as off medication at the end of the follow-up period). Sur vival curve methods were used to estimate the duration of medication t reatment for those with remission. Of the 504 eligible patients, appro ximately 70% become seizure free long enough to discontinue medication . Approximately 70% of those stopping medication o first time remained seizure free. At the end of follow-up, 55% of the total cohort were i n remission. At diagnosis, the best predictors of remission were age < 12 years at onset, normol intelligence, no prior neonatal seizures, an d fewer than 21 seizures before treatment. If predicted to have a remi ssion, then, on the basis of survival curve analysis, 80% were without medication 100 months after diagnosis. After 12 months of treatment, prediction was enhanced by including a score for the number of seizure s between 6 and 12 months on treatment. We conclude that approximately 55% of childhood epilepsy will remit. Our scoring system predicts rea sonably accurately who will have a remission and when medication is li kely to be discontinued.