Prognosis of idiopathic epilepsies with absences Volume 16, issue 2, Avril-Mai-Juin 2004


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Département de Neurologie, Clinique Neurologique, 1, place de l’hôpital. 67091 Strasbourg, France Département de Pédiatrie, Strasbourg, France

From the literature complete remission of absences varies from 33% to 78% and is 47% in the present study. Generalized tonic‐clonic seizures (GTCS) may appear, whether absence seizures persist or have disappeared for several years. It has been estimated that GTCS occurred in 36 to 60% of the patients with onset of absence seizures in childhood. These figures are of dubious significance: childhood onset absence seizures are not necessarily "pure absence epilepsy". In the present study, 47.5% of patients showed GTCS during the course of the epilepsy. Most often, GTCS occur 5 to 10 years after onset of absence seizures, mainly between 8 and 15 years of age and sometimes beyond 20 and even 30 years of age. They have been considered as infrequent and easily controlled. Even with a complete remission of seizures the social adaptation of patients is often poor. Age at onset and medication efficacy are favorable prognostic signs. Photosensitivity, early occurrence of GTCS, poly‐spikes as an ictal pattern of absences are unfavorable prognostic signs.