A long-term follow-up study of first episodes of idiopathic status convulsivus in childhood: in relation to subsequent epilepsy (second report).

Abstract

Fifty-four idiopathic status convulsivus (SC) cases were followed prospectively for a period between 5 and 21 years, the average being 13 years. Three-fourths of the cases had no residuals. There were two patterns of subsequent epilepsy; 1) complex partial seizures (CPS) with or without secondarily generalization (GTS) developed 4.3 +/- 3.5 years after febrile SC, 2) unilateral seizures or CPS +/- GTS developed 1.2 +/- 1.0 years after afebrile SC. The seizure prognosis of these cases was good except for some cases in the former group. There have been two kinds of theories regarding SC and epilepsy until now. One was derived from retrospective studies: SC and/or complex febrile convulsion (FC) were considered the main causes of temporal lobe epilepsy (TLE) producing mesial temporal sclerosis (MTS). Another was derived from prospective studies, in which the relation between FC and TLE was considered weak. Our results revealed that 6 cases (15%) out of 30 febrile SC developed epilepsy, and that five of those six cases were diagnosed as CPS. Three of 5 CPS cases were diagnosed as TLE. Recently the seizure prognosis of operative therapy for TLE--especially the MTS type--has been very favorable. Furthermore, it has become easy to find MTS by Magnetic Resonance Imaging (MRI). So, we emphasize that a precise follow-up study of SC using MRI, EEG, etc., is important in deciding the appropriate therapy for TLE, as well as in the study of the pathogenesis of TLE.