Objective: To investigate the probability of achieving control of seizures after initiating treatment in childhood epilepsy.
Patients and methods: 106 children aged under 14 years newly diagnosed of epilepsy were started on antiepileptic treatment and prospectively followed.
Results: Antiepileptic drug levels were monitored and compliance was satisfactory. The Kaplan Meier estimate of the probability of achieving a 2 year initial remission was 55%, 71%, 77%, 86% and 96% at 2, 2.5, 3, 4 and 5 years, respectively. Multivariate analysis using the Cox proportionate hazards model showed that a symptomatic etiology, an abnormal EEG and recurrence of seizures during the first six months of treatment reduced the probability of achieving a 2 year initial remission, while the presence of generalized tonic clonic seizures or partial secondarily generalized seizures exclusively and a patient age of 3 10 years increased it. Stepwise selection of the variables showed that the best model for prediction of remission was that composed of age 3 10 years and recurrence during the first six months of treatment. Differences among epileptic syndromes couldn t be demonstrated.
Conclusions: Most children with epilepsy achieved a remission after initiating antiepileptic treatment. Those 3 10 years old or without recurrences during the first six months have a particularly favorable outcome.