It has never been clear whether children who suffer from epilepsy would be affected by their condition as adults until a recently published study made the headlines. Researchers in Finland began a study on pediatric epileptic patients in 1964. This long-term study tracked the children as they grew into adulthood. The participants received routine follow up visits every five years until 2002, with the last visit in 2014. At different phases of the study, researchers drew new conclusions based on the data.
The children in the study were an average age of four years old when the study began in 1964. The study consisted of 245 children diagnosed with epilepsy. Half of the participants suffered from seizures with no underlying cause and were considered normal in all other aspects. The other half of the participants possessed clear and undeniable triggers like trauma and brain injury.
Outcomes: 40 Years Later
Forty years later, researchers concluded that when epilepsy starts in childhood and continues into adulthood, the risk of dying is increased three-fold over the general population.
High Remission at the 45 Year Mark
At the 45-year follow up, 61% of the surviving participants were in remission for 10 years or longer. Out of the original 245 children, 179 had survived. This result is triple the average in Finland for this age group.
Out of the 179 participants, 133 agreed to continue the study. Of the 133 people, 43% were off anti-seizure medication due to remission. The study reported that the cause of the epileptic seizures might be connected to the long-term outcome. The following outlines the outcomes at the 45 year follow up:
95% of participants with Idiopathic epilepsy were in remission. Idiopathic participants were those considered normal with no brain abnormalities.
72% of participants with Cryptogenic epilepsy were in remission. Cryptogenic participants may have had a cause for their epilepsy, but it remained hidden or of an unknown origin.
47% of participants with Symptomatic epilepsy were in remission. Symptomatic participants suffered epileptic seizures as a symptom of another underlying condition or due to trauma.
Remission was defined as being free of seizures for five years, on or off medication.
What showed up 50 years later
At the 50-year follow up, 51 patients participated. All 51 had uncomplicated epilepsy. 39% displayed central nervous system signs compared to 13% of the controls and 6% had peripheral signs compared to 13% of the controls, according to the study. The researchers found it “striking” to see that patients exhibited a higher rate of abnormalities during brain imaging related to Cerebrovascular disease than the controls.
Since there were no differences in the serum markers for Cerebrovascular disease, the researchers reported, "This suggests that it is the epilepsy, including the underlying etiology, seizures and treatment that may be responsible for these early changes." The early changes not only include seizures, but also the cause of the epilepsy and its treatment. Those patients that outgrew the seizures and no longer were taking anti-seizure medication were at a low risk for mortality, compared to their peers. Neurologists believe that those with uncontrolled epilepsy should be treated more aggressively and that surgery outperforms medications. Yet, some doctors believe surgery is underutilized.
The researchers suggest that patients with childhood-onset epilepsy should work closely with their physician on a consistent treatment plan as well as avoid extreme sports and lifestyle. Patients should consult with the physician or neurologist before making any big changes in medication or treatment. Parents of pediatric epileptic patients can demonstrate to their children the benefit of effective communication between the family and the physician.
RSC Diagnostic Services delivers in-home ambulatory long-term video EEG. RSC empowers physicians by increasing the diagnostic yield to evaluate, diagnose and treat a variety of neurological symptoms. We are committed to improving patient outcomes and enhancing caregiving.