Matti Sillanpää1, Anu Anttinen2, Juha O Rinne3, Juho Joutsa3, Pirkko Sonninen4, Matti Erkinjuntti5, Bruce Hermann6, Mira Karrasch7, Maiju Saarinen8, Petri Tiitta9, Shlomo Shinnar10. 1. Department of Child Neurology, Turku University Hospital, Turku, Finland. 2. Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland. 3. Turku PET Centre, Turku, Finland. 4. VSKK, TYKS-SAPA, Turku, Finland. 5. Department of Clinical Neurophysiology, Turku University Hospital, Turku, Finland. 6. Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A. 7. Department of Psychology, Abo Akademi University, Turku, Finland. 8. Department of Public Health, University of Turku, Turku, Finland. 9. Turku Teacher Training College, University of Turku, Turku, Finland. 10. Departments of Neurology, Pediatrics and Epidemiology and Public Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, U.S.A.
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. Wiley Periodicals, Inc.
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. Wiley Periodicals, Inc.
Authors: Camille Garcia-Ramos; Sam Bobholz; Kevin Dabbs; Bruce Hermann; Juho Joutsa; Juha O Rinne; Mira Karrasch; Vivek Prabhakaran; Shlomo Shinnar; Matti Sillanpää Journal: Hum Brain Mapp Date: 2017-04-03 Impact factor: 5.038
Authors: Mira Karrasch; Petri Tiitta; Bruce Hermann; Juho Joutsa; Shlomo Shinnar; Juha Rinne; Anu Anttinen; Matti Sillanpää Journal: J Int Neuropsychol Soc Date: 2017-01-10 Impact factor: 2.892
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Authors: Anny Reyes; Erik Kaestner; Emily C Edmonds; Anna Christina Macari; Zhong Irene Wang; Daniel L Drane; Vineet Punia; Robyn M Busch; Bruce P Hermann; Carrie R McDonald Journal: Epilepsia Date: 2020-12-01 Impact factor: 5.864