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，这是残疾的重要来源。 这项申请延续了1993年开始的一项基于社区的613项研究 从16/17名儿童神经科医生招募新诊断的癫痫儿童 在康涅狄格州。基线数据是通过病历审查和 家长面谈。每3个月审查一次后续记录和电话 是主要的后续机制。这项研究的一个重要特点是 纳入国际癫痫分类进行研究 根据证候(具体诊断)而不是症状判断预后 和特征(例如，癫痫类型)。识别风险的最初主要目标 顽固性癫痫和两年缓解期以及继发性癫痫的预测因素 目标已经得到解决。来自多个来源的最新信息表明 长期结果在短期内可能不会被充分认识到， 具体地说，在几年的沉默之后，这种棘手的情况可能会出现。 其他证据表明，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？ 还没有完全被理解。拟议的研究将继续开展以下后续行动 该队列用于检查癫痫的结果(例如，较晚发病的顽固性和 缓解和复发)又持续了几年。此外，一个标准化的 计划进行神经心理和教育评估以及核磁共振检查--9年 在初步诊断后。核磁共振成像是专门为检测海马区而设计的 萎缩症(HA)是难治性局灶性癫痫中常见的病变，但 在这个队列中，只有3/388名儿童在确诊时接受了核磁共振检查。这 研究将允许对医管局进行检查，并将其与 确诊时的癫痫(例如，发热性癫痫史、癫痫持续状态、 癫痫发作类型)，并在九年的过程中提供知识 这最终可能有助于预防一些最极端的癫痫形式。 这项研究的数据将提供有价值的信息，可能导致 各种干预措施的设计和目标，包括社会干预和 教育干预和新的神经保护措施 可用。这反过来有助于减轻与以下方面相关的负担 儿童和青少年发作的癫痫，个人，家庭和 社会作为一个整体。

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.