Clinical evolution and prognosis of childhood epilepsies.

Five-hundred twelve epileptic children were followed longitudinally for several years. The 2- and 4-year remission statuses at the latest examination were 50.6 and 44.2%, respectively. Dividing our sample into groups showing onset of seizures in infancy or at 2-3, 4-7, 8-10, or 11-14 years, the remission rates were as follows: 48.5, 67.6, 49, 46, and 33.3%. The rates of remission of generalized and focal epilepsies were similar (52.9 and 49.7%, respectively; chi 2 = 0.293; p greater than 0.5). The earlier the onset of seizures, the higher is the probability of their association with mental subnormality and neurologic deficits. Generalized epilepsies are more strongly associated with mental subnormality (40.1%) than are the focal epilepsies (13%), and the focal epilepsies are associated with neurologic deficit almost twice as frequently as are the generalized epilepsies (12.2 vs. 7.3%). Epidemiologically, the EEG is of little prognostic importance. The combined percentage of normalized (19%) and stabilized (17%) EEGs remains lower than the percentage of remission.