The Early Prognosis of Epilepsy in Childhood: The Prediction of a Poor Outcome. The Dutch Study of Epilepsy in Childhood
Summary: Purpose: To examine which variables available early in the course of childhood epilepsy are associated with a poor short‐term outcome and to develop models to predict such an outcome. Methods: We prospectively followed up 466 children with newly diagnosed epilepsy for 2 years. Variables were collected at intake and after 6 months. Outcome was defined as the duration of the terminal remission (TR): poor (<6 months) and not poor (≥6 months). Results: Of the subjects, 31% had a poor outcome. Multivariate analysis based on the intake variables identified number of seizures, seizure typ... Mehr ...
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Dokumenttyp: | Artikel |
Erscheinungsdatum: | 1999 |
Reihe/Periodikum: | Epilepsia ; volume 40, issue 6, page 726-734 ; ISSN 0013-9580 1528-1167 |
Verlag/Hrsg.: |
Wiley
|
Sprache: | Englisch |
Permalink: | https://search.fid-benelux.de/Record/base-27467935 |
Datenquelle: | BASE; Originalkatalog |
Powered By: | BASE |
Link(s) : | http://dx.doi.org/10.1111/j.1528-1157.1999.tb00770.x |
Summary: Purpose: To examine which variables available early in the course of childhood epilepsy are associated with a poor short‐term outcome and to develop models to predict such an outcome. Methods: We prospectively followed up 466 children with newly diagnosed epilepsy for 2 years. Variables were collected at intake and after 6 months. Outcome was defined as the duration of the terminal remission (TR): poor (<6 months) and not poor (≥6 months). Results: Of the subjects, 31% had a poor outcome. Multivariate analysis based on the intake variables identified number of seizures, seizure type, and etiology as risk factors for a poor outcome. With the intake and 6‐month variables combined, seizure type, etiology, the number of seizures, and not attaining a 3‐month remission during these 6 months, and the EEG at 6 months were predictive variables. A predictive model based on the multivariate logistic‐regression analysis with the intake variables was correct in 56% of the children in whom it predicted a poor outcome and in 73% of the children in whom it predicted a not‐poor outcome. With the intake and 6‐month variables together, these percentages were 66 and 79%, respectively. The sensitivity of these models was low (29 and 47%, respectively); the specificity was good (90 and 89%). Conclusions: The 2‐year outcome of childhood epilepsy is closely related to its early course. The prognosis is poor in −30% of patients. By using our data, the prediction of a poor outcome is correct in almost two thirds of the patients; however, the models produce many false‐negative predictions.