The early prognosis of epilepsy in childhood: The prediction of a poor outcome. The Dutch study of epilepsy in childhood

被引:100
作者
Arts, WFM
Geerts, AT
Brouwer, OF
Peters, ACB
Stroink, H
van Donselaar, CA
机构
[1] Erasmus Univ, Med Ctr, Dept Pediat Neurol, NL-3015 GJ Rotterdam, Netherlands
[2] Erasmus Univ, Med Ctr, Dept Neurol, NL-3015 GJ Rotterdam, Netherlands
[3] Leiden Univ, Med Ctr, Dept Pediat Neurol, Leiden, Netherlands
[4] Univ Utrecht Hosp, Wilhelmina Childrens Hosp, Utrecht, Netherlands
[5] Juliana Childrens Hosp, Dept Neurol, The Hague, Netherlands
[6] Westeinde Ziekenhuis, Dept Neurol, The Hague, Netherlands
关键词
epilepsy; childhood; prognosis; prognostic model; outcome;
D O I
10.1111/j.1528-1157.1999.tb00770.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose: To examine which variables available early in the course of childhood epilepsy are associated with a poor short-term outcome and to develop models to predict such an outcome. Methods: We prospectively followed up 466 children with newly diagnosed epilepsy for 2 years. Variables were collected at intake and after 6 months. Outcome was defined as the duration of the terminal remission (TR): poor (<6 months) and not poor (greater than or equal to 6 months). Results: Of the subjects, 31% had a poor outcome. Multivariate analysis based on the intake variables identified number of seizures, seizure type, and etiology as risk factors for a poor outcome. With the intake and 6-month variables combined, seizure type, etiology, the number of seizures, and not attaining a 5-month remission during these 6 months, and the EEG at 6 months were predictive variables. A predictive model based on the multivariate logistic-regression analysis with the intake variables was correct in 56% of the children in whom it predicted a poor outcome and in 73% of the children in whom it predicted a not-poor outcome. With the intake and 6-month variables together, these percentages were 66 and 79%, respectively. The sensitivity of these models was low (29 and 47%, respectively); the specificity was good (90 and 89%). Conclusions: The 2-year outcome of childhood epilepsy is closely related to its early course. The prognosis is poor in -30% of patients. By using our data, the prediction of a poor outcome is correct in almost two thirds of the patients; however, the models produce many false-negative predictions.
引用
收藏
页码:726 / 734
页数:9
相关论文
共 24 条
[1]  
ALTMAN DG, 1990, STAT CONFIDENCE CONF, P83
[2]   REMISSION OF SEIZURES AND RELAPSE IN PATIENTS WITH EPILEPSY [J].
ANNEGERS, JF ;
HAUSER, WA ;
ELVEBACK, LR .
EPILEPSIA, 1979, 20 (06) :729-737
[3]  
[Anonymous], 1981, Epilepsia, V22, P489
[4]  
[Anonymous], 1993, EPILEPSIA, V34, P592
[5]   Predictors of intractable epilepsy in childhood: A case-control study [J].
Berg, AT ;
Levy, SR ;
Novotny, EJ ;
Shinnar, S .
EPILEPSIA, 1996, 37 (01) :24-30
[6]   LONG-TERM PROGNOSIS IN CHILDHOOD EPILEPSY - SURVIVAL AND SEIZURE PROGNOSIS [J].
BRORSON, LO ;
WRANNE, L .
EPILEPSIA, 1987, 28 (04) :324-330
[7]  
BROUWER OF, 1995, EPILEPSIA, V36, pS28
[8]   OUTCOME OF CHILDHOOD EPILEPSY - A POPULATION-BASED STUDY WITH A SIMPLE PREDICTIVE SCORING SYSTEM FOR THOSE TREATED WITH MEDICATION [J].
CAMFIELD, C ;
CAMFIELD, P ;
GORDON, K ;
SMITH, B ;
DOOLEY, J .
JOURNAL OF PEDIATRICS, 1993, 122 (06) :861-868
[9]   Incidence of epilepsy in childhood and adolescence: A population-based study in Nova Scotia from 1977 to 1985 [J].
Camfield, CS ;
Camfield, PR ;
Gordon, K ;
Wirrell, E ;
Dooley, JM .
EPILEPSIA, 1996, 37 (01) :19-23
[10]   Epilepsy in childhood -: An audit of clinical practice [J].
Carpay, HA ;
Arts, WFM ;
Geerts, AT ;
Stroink, H ;
Brouwer, OF ;
Peters, ACB ;
van Donselaar, CA .
ARCHIVES OF NEUROLOGY, 1998, 55 (05) :668-673