Prognosis of epilepsy in a community-based study: 8 years of follow-up in an Argentine community

Objective -To assess the prognosis of epilepsy, the possibility of achieving remission of seizures, in patients who were identified in a population-based study carried out in Junin, a city of about 70,000 inhabitants in Buenos Aires Province, Argentina. On January 1, 1991 (prevalence day), 106 people had epilepsy, including 64 (60%) with the condition active. Methods -Eight years later, we revisited the patients identified in the prevalence study. We analyzed risk factors in relation to remission of seizures. We also confirmed the specific cause of death. Results -Ninety-six patients were revisited (10 were completely lost to follow-up). We divided them into two groups: the group in terminal remission (defined as a seizure-free period that extended from prevalence day until the visit day in 1998) which included 64 people (66.7%), and the group of those who continued to have seizures which included 32 (33.3%) patients, of whom eight (25%) died. The overall standardized mortality ratio was 2.45; the rate was two and a half times that of the general national population. Conclusion -The better prognosis was observed in the group with generalized idiopathic epilepsy syndrome. Patients with epilepsy secondary to underlying structural causes had the worst prognosis, with higher mortality.