Abstract
It is often difficult to formulate a therapeutic principle for convulsive disorders in infancy, because etiologies, clinical features and prognoses are very complex.
The purpose of this study was to evaluate the prognosis of 123 patients who presented afebrile convulsions in infancy, but did not exhibit paroxysmal discharges on the initial EEG recordings. Among them, 68 patients followed up for more than four years were divided into the well-controlled (53 cases) and poorly-controlled (15 cases) groups, whereas outcomes of 55 other patients were not assessed because of shorttime observation.
There were no differences in the mean or range of age of onset and between both sexes among three groups. An incidence of positive family history of convulsions was high in each group. 4 patients (8%) in the well-controlled group had a family history of benign infantile convulsion being the same disorder with those of the probands. The incidence of psychomotor retardation was the highest in the poorly-controlled group.
As to the triggering factors of convulsions, diarrhea was observed in 3 (6%) of the well-controlled and 12 (22%) of the unkown prognosis group, but none in the poorly-controlled group. Types of convulsions were mostly either generalized tonic-clonic or tonic seizure of less than 3 minutes duration. In the well-controlled group, seizures tended to recur in clusters within a day. Many cases in the poorly-controlled group showed abnormalities of the basic activity in the initial EEG.
A follow up observation showed that in the well-controlled group clinical seizures disappeared usually before 3 years of age, while in the poorly-controlled group many cases showed focal spike-waves and transformed their seizure types during the course.
