Long-Term Outcomes of Childhood-Onset Epilepsy

描述（由申请人提供）：癫痫影响1- 2%的 在许多受影响的人中，这是残疾的一个重要来源。 这项申请是1993年开始的一项以社区为基础的研究的继续， 从16/17名儿童神经科医生招募的新诊断癫痫儿童 在康涅狄格州通过病历审查收集基线数据， 家长访谈每3个月审查后续记录和电话 是主要的后续机制。这项研究的一个重要特点是， 纳入国际癫痫分类， 综合征（特异性诊断）而非症状的预后 和特征（例如癫痫发作类型）。识别风险的最初主要目标 难治性癫痫和2年缓解的预测因素， 目标已经实现。来自多个来源的最新信息表明， 短期内可能无法充分认识到长期成果， 具体地说，在几年的沉寂之后，可能会出现棘手问题。 更多的证据表明，长期的社会，行为和 与儿童癫痫发作相关的教育结果。为什么会这样 还没有被完全理解。拟议的研究将继续对 该队列检查癫痫发作结局（例如，晚发型顽固性和 缓解和复发）。此外，标准化 计划在9年内进行神经心理学和教育评估以及MRI检查 初步诊断后。磁共振成像是专门用来检测海马 萎缩（HA）是难治性局灶性癫痫中常见的病变， 仅见于该队列中诊断时进行MRI的3/388名儿童。这 研究将允许检查HA与 诊断时的癫痫（例如，热性惊厥史，癫痫持续状态， 九年之久，知之甚详。 这可能最终有助于预防一些最极端形式的癫痫。 这项研究的数据将提供有价值的信息， 设计和定向各种干预措施，包括社会和 教育干预和新的神经保护措施， available.这反过来又有助于减轻与 儿童期和癫痫发作的个人，家庭， 社会大局

DESCRIPTION (provided by applicant): Epilepsy affects 1-2 percent of the population and is a significant source of disability in many of those affected. This application continues a community-based study begun in 1993 of 613 children with newly diagnosed epilepsy recruited from 1 6/17 child neurologists in Connecticut. Baseline data were collected through medical record review and parent interviews. Review of subsequent records and phone calls every 3 months are the main follow-up mechanisms. An important feature of this study is the incorporation of the International Classification of the Epilepsies to study prognosis with respect to syndrome (specific diagnosis) rather than symptoms and features (e.g. seizure type). The initial primary goals of identifying risk and predictors of intractable epilepsy and two-year remission and the secondary goals have been addressed. Recent information from several sources indicates that long-term outcomes may not be fully appreciated in the short-term and specifically that intractability may occur after several years of quiescence. Additional evidence indicates long-term compromised social, behavioral, and educational outcomes associated with pediatric onset epilepsy. Why this is so is not fully understood. The proposed study would continue the follow-up of this cohort to examine seizure outcomes (e.g. later onset intractability and remission and relapse) over several more years. In addition, a standardized neuropsychological and educational assessment and a MRI are planned -9 years after initial diagnosis. The MRI is specifically designed to detect hippocampal atrophy (HA) a common lesion seen in refractory focal epilepsy but which was only seen in 3/388 children in this cohort who had MRIs at diagnosis. This study will permit examination and correlation of HA with details of the epilepsy at diagnosis (e.g. history of febrile seizures, status epilepticus, seizure types) and over the course of nine years and thus provide knowledge that may ultimately help prevent some of the most extreme forms of epilepsy. The data from this study will provide valuable information that could lead to the design and targeting of a variety of interventions, including social and educational interventions and new neuroprotective measures as they become available. This in turn could help lessen the burdens associated with childhood-and adolescent-onset epilepsy for the individual, the family, and society as a whole.