Transient seizure remission in intractable localization-related epilepsy

We sought to elucidate the clinical features of transient seizure remission in intractable cryptogenic or symptomatic localization-related epilepsy of childhood onset, Transient seizure remission has been reported to occur in mesial temporal sclerosis or focal cortical dysplasia, but few reports hav e focused on this phenomenon. We retrospectively scrutinized the temporal p rofiles of seizure frequency of 99 patients with intractable localization-r elated epilepsy by reviewing their medical charts. Ten patients (10%) had t ransient seizure remissions that lasted for 2 years or longer. When an appr opriate antiepileptic agent was administered, seizure remission occurred wi thin 1-18 months. Without any triggering factors, the seizures recurred abr uptly in seven patients and gradually in three. Epileptiform discharges on electroencephalography disappeared during the transient remission in seven patients and reappeared in five of them after recurrence, After recurrence, no antiepileptic agent was able to control the seizures. In comparison wit h those without transient seizure remission, these 10 patients tended to ha ve normal intelligence and a positive family history for epilepsy. Transien t seizure remission occurs in a variety of pathologic changes and may be a result of an interaction between the progressive nature of some types of ep ileptogenic foci and an effect of the antiepileptic drugs. (C) 2000 by Else vier Science Inc. All rights reserved.