Childhood-onset epilepsy five decades later. A prospective population-based cohort study

Matti Sillanpää, Anu Anttinen, Juha O. Rinne, Juho Joutsa, Pirkko Sonninen, Matti Erkinjuntti, Bruce Hermann, Mira Karrasch, Maiju Saarinen, Petri Tiitta, Shlomo Shinnar

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

Objective To study the impact of childhood-onset epilepsy on a variety of outcomes across the life span. Methods A population-based cohort of 245 subjects with childhood-onset epilepsy was assessed for outcomes at 45 years. In addition, 51 of 78 surviving subjects with uncomplicated epilepsy and 52 of 99 originally matched controls participated in a detailed evaluation including electroencephalography (EEG), imaging, and laboratory studies at 50 years. Results Of 179 surviving subjects, 61% were in terminal 10-year remission and 43% in remission off medications. At 45 years, 95% of the idiopathic group, 72% of the cryptogenic group, and 47% of the remote symptomatic group were in terminal remission (p <0.001). Abnormal neurologic signs were significantly more common in subjects with uncomplicated epilepsy than in controls. Mortality during period 1992-2012 was higher in subjects than in controls (9% vs. 1%, p = 0.02). The rate of 3T MRI abnormalities was higher in subjects than in controls (risk ratio [RR] 2.0; 1.3-3.1) specifically including findings considered markers of cerebrovascular disease (RR 2.5; 1.04-5.9). Even subjects with idiopathic epilepsy had higher rates of imaging abnormalities than controls (73% vs. 34%, p = 0.002). Significance Long-term seizure outcomes are excellent and a function of etiology. The presence of imaging abnormalities suggestive of vascular disease may put these subjects at higher risk for clinically evident stroke and cognitive changes as they age.

Original languageEnglish (US)
Pages (from-to)1774-1783
Number of pages10
JournalEpilepsia
Volume56
Issue number11
DOIs
StatePublished - Nov 1 2015

Keywords

  • Childhood-onset epilepsy
  • Comorbidity of epilepsy
  • Long-term outcome
  • Prospective cohort study

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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    Sillanpää, M., Anttinen, A., Rinne, J. O., Joutsa, J., Sonninen, P., Erkinjuntti, M., Hermann, B., Karrasch, M., Saarinen, M., Tiitta, P., & Shinnar, S. (2015). Childhood-onset epilepsy five decades later. A prospective population-based cohort study. Epilepsia, 56(11), 1774-1783. https://doi.org/10.1111/epi.13187