Abstract
Childhood epilepsy without organic lesion is thought to have a good prognosis, but some cases have relapses after a long seizure-free period. In this study, we studied relapses of seizures clinically.
1) We studied 20 cases who were diagnosed as epilepsy and were treated at the pediatric clinics of Keio University Hospital and 3 affiliated hospitals and had relapses after a seizure-free period of three years or more.
In the majority of these cases, seizures recurred after the age of puberty. Thirteen cases had primary generalized epilepsy which had been thought to have a good prognosis.
The presumptive triggers of relapses were poor compliance of drugs, fatigue emotional stress, acute infective diseases, and menstruation. Of these triggers, poor compliance of drugs was the most important. And only 3 cases had no such triggers.
In 6 cases, the epileptic discharges reappeared in EEG within 2 years after relapses, and it was only in 3 cases that the epileptic discharges reappeared within 2 years before relapses. Therefore, it is difficult to predict the relapses by the use of EEG findings.
2) Two hundred and twenty one epileptic patients with a seizure-free period of 3 years or more were followed for 3 years to 13 years 9 months to know the relapse rate.
Seizures recurred in 14 cases, so the relapse rate was 6.3%: 4.1% in cases on unchanged medication, 10.9% during drug reduction, and 10.7% after withdrawal
