Abstract
To study the evolution of epilepsy associated with infantile hemiparesis (IH) in relation
to age and identification of factors predictive of pharmacoresistance. Thirty-four
children with epilepsy and associated IH were followed for a period of 13 years and
3 months (range 5–19 years). All the patients underwent clinical evaluation and EEG,
CT and/or MRI. Disease course was evaluated from the time of diagnosis of epilepsy
to end of follow-up by differentiating the cases with severe pharmacoresistance from
those with favourable outcome. Several possible prognostic factors were identified
predicting evolution toward intractable epilepsy. Univariate statistical analysis
by calculating odds ratio (OR) with 95% confidence interval (CI) and multivariate
analysis by logistic regression were performed. Eleven cases presented severe epilepsy
evolving toward pharmacoresistance; duration of epilepsy was always longer than 8
years. Twenty-three cases (seven with severe epilepsy and 16 with mild epilepsy) evolved
toward remission; in these patients epilepsy duration was shorter (2–7 years) and
a complete remission was obtained within 12 years of age. Significant prognostic factors
associated with pharmacoresistance included: non-vascular causes, cortical lesions,
mixed and frequent seizures during the first two years of epilepsy. Our results show
that surgical treatment could be considered in cases with unfavourable prognostis
factors.
Keywords
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Article info
Publication history
Accepted:
July 18,
2000
Received in revised form:
June 21,
2000
Received:
December 14,
1999
Identification
Copyright
© 2001 Elsevier Science B.V. Published by Elsevier Inc. All rights reserved.
