Abstracts

To investigate how often a clear-cut prognosis is determined by a specific syndrome diagnosis in childhood epilepsy.
We studied 26 specific syndromes from the ILAE classification. A specific syndrome appears at the end of the algorithmic classification tree. For each specific syndrome we searched Medline (Pubmed 1966 - 2002) for peer-reviewed publications with [ge] 25 patients followed for [ge] 2 years. Different series were not combined to avoid variation in syndrome definition. The published papers of all possible abstracts were reviewed. Remission was defined as a terminal remission (seizure-free) for [ge] 1 year with or without medication.
8592 abstracts were reviewed. 12 of 26 syndromes had no publication meeting our criteria. 5 of 14 syndromes with an adequate publication have a definite prognosis (excellent or poor), while 9 of 14 have an intermediate prognosis (some patients remit, some do not). Only two syndromes are guaranteed to have permanent remission [ndash] benign childhood epilepsy with centro-temporal spikes and benign familial infantile seizures. Three are guaranteed not to remit [ndash] Lennox Gastaut, Dravet and Rasmussen syndrome. Most syndromes have a prognosis in between these two extremes; however, the literature is inadequate to come to a conclusion for 12 of 26 syndromes.
Currently, for most childhood onset epilepsy a syndrome diagnosis does not give an accurate prognosis for an individual patient.