PREDICTING OUTCOME OF CHILDHOOD ABSENCE SEIZURES

Objectives: Absence seizures outcome remains poorly delineated. Long-term remission occurs in two-thirds of cases. The objective of this study was to determine the clinical variables at diagnosis which could identify a person who would be seizure free for greater than one year at 18 to 24 months post-diagnosis.

Methods: Case ascertainment was through EEG records of the Children's Hospital of Eastern Ontario. Inclusion criteria were between 1 and 18 years of age, history of absence seizures, EEG with general spike wave, and diagnosis and antiepileptic medication initiated by a pediatric neurologist. Exclusion criteria included traumatic head injury or presence of neuro-degenerative disorder. Retrospective chart review for age at onset, duration of symptoms prior to diagnosis, time of first remission, seizure description, family history, school status, and neurological examination was done. Independent blinded re-reading of initial EEG tracing was done.

Results: 65 cases were included. 58.5% were female. Mean age at diagnosis was 6.93 years. 50.8% had only absence attacks. 32.5%had family history of afebrile seizures. 90.8% had normal cognition. 45% were seizure free for greater than one year 18months after diagnosis. Absence only seizures, history of febrile seizures and shorter time to remission were associated with good outcome.

Conclusion: Variables predictive of being seizure free for over one year at 18 months after diagnosis of generalized absence seizure disorder included simple absence attacks, history of febrile seizures and shorter time to remission.