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SEATTLE—Among people with epilepsy, the degree of intellectual disability in childhood may predict seizure outcome in adulthood, according to data described at the 68th Annual Meeting of the American Epilepsy Society.
Scientists at Dalhousie University in Halifax, Canada, conducted decades of research to determine whether intellectual disability predicts a low chance of remission and a high risk of intractability in epilepsy. Eligible participants were children from Nova Scotia, Canada, who developed epilepsy between 1977 and 1985 and had intellectual disability. The researchers followed the children for an average of 21 years following diagnosis. The initial study followed 692 children with incident epilepsy, of whom 147 (21%) had intellectual disability. The investigators administered standard psychometric testing when the children were approximately age 5 to establish the degree of intellectual disability, which was confirmed by subsequent academic achievements.
Among patients with epilepsy, the degree of intellectual disability is mild in approximately 25%, moderate in approximately 25%, and severe in approximately 50%. “In children with epilepsy, there is a large overrepresentation by those who have severe intellectual disability,” said Peter Camfield, MD, Professor Emeritus in the Department of Pediatrics at Dalhousie University.
Mild intellectual disability was associated with a substantially better prognosis for remission and absence of intractability than moderate or severe intellectual disability. Focal epilepsy with mild intellectual disability had the same rates of remission and intractability as focal epilepsy with normal intelligence. Although mild intellectual disability significantly affects social outcome, it is not an important prognostic factor for seizure outcome, particularly if the epilepsy is focal, said the researchers.
The level of intellectual disability varied by the type of epilepsy. Focal epilepsy was present in 70% of individuals with mild intellectual disability, 38% of patients with moderate intellectual disability and 29% of participants with severe intellectual disability. Generalized symptomatic epilepsies were more common among patients with moderate (53%) and severe (65%) intellectual disability than among patients with mild intellectual disability (13%). Participants with mild intellectual disability were more likely to be in remission at the end of the 20-year follow up (50%) than participants with moderate (34%) or severe (28%) intellectual disability. Intractable epilepsy was more common among subjects with moderate (35%) and severe (59%) intellectual disability than among people with mild intellectual disability (17%).
“Mild intellectual disability has a profound effect on a child’s adaptation to adult life,” said Dr. Camfield. “However, it is not particularly associated with severe epilepsy. Moderate to severe intellectual disability has ominous implications for seizure control.”
The study’s results “can be reassuring for families who have a child with mild intellectual disability that there’s still a very good chance that their epilepsy is going to settle and it won’t be too, too bad,” continued Dr. Camfield. “That’s important because those children, by definition, are mobile [and] will be in the community, so the concern about epilepsy control is probably greater than for the children with profound disability who are going to be under supervision all the time.”
—Erik Greb
SEATTLE—Among people with epilepsy, the degree of intellectual disability in childhood may predict seizure outcome in adulthood, according to data described at the 68th Annual Meeting of the American Epilepsy Society.
Scientists at Dalhousie University in Halifax, Canada, conducted decades of research to determine whether intellectual disability predicts a low chance of remission and a high risk of intractability in epilepsy. Eligible participants were children from Nova Scotia, Canada, who developed epilepsy between 1977 and 1985 and had intellectual disability. The researchers followed the children for an average of 21 years following diagnosis. The initial study followed 692 children with incident epilepsy, of whom 147 (21%) had intellectual disability. The investigators administered standard psychometric testing when the children were approximately age 5 to establish the degree of intellectual disability, which was confirmed by subsequent academic achievements.
Among patients with epilepsy, the degree of intellectual disability is mild in approximately 25%, moderate in approximately 25%, and severe in approximately 50%. “In children with epilepsy, there is a large overrepresentation by those who have severe intellectual disability,” said Peter Camfield, MD, Professor Emeritus in the Department of Pediatrics at Dalhousie University.
Mild intellectual disability was associated with a substantially better prognosis for remission and absence of intractability than moderate or severe intellectual disability. Focal epilepsy with mild intellectual disability had the same rates of remission and intractability as focal epilepsy with normal intelligence. Although mild intellectual disability significantly affects social outcome, it is not an important prognostic factor for seizure outcome, particularly if the epilepsy is focal, said the researchers.
The level of intellectual disability varied by the type of epilepsy. Focal epilepsy was present in 70% of individuals with mild intellectual disability, 38% of patients with moderate intellectual disability and 29% of participants with severe intellectual disability. Generalized symptomatic epilepsies were more common among patients with moderate (53%) and severe (65%) intellectual disability than among patients with mild intellectual disability (13%). Participants with mild intellectual disability were more likely to be in remission at the end of the 20-year follow up (50%) than participants with moderate (34%) or severe (28%) intellectual disability. Intractable epilepsy was more common among subjects with moderate (35%) and severe (59%) intellectual disability than among people with mild intellectual disability (17%).
“Mild intellectual disability has a profound effect on a child’s adaptation to adult life,” said Dr. Camfield. “However, it is not particularly associated with severe epilepsy. Moderate to severe intellectual disability has ominous implications for seizure control.”
The study’s results “can be reassuring for families who have a child with mild intellectual disability that there’s still a very good chance that their epilepsy is going to settle and it won’t be too, too bad,” continued Dr. Camfield. “That’s important because those children, by definition, are mobile [and] will be in the community, so the concern about epilepsy control is probably greater than for the children with profound disability who are going to be under supervision all the time.”
—Erik Greb
SEATTLE—Among people with epilepsy, the degree of intellectual disability in childhood may predict seizure outcome in adulthood, according to data described at the 68th Annual Meeting of the American Epilepsy Society.
Scientists at Dalhousie University in Halifax, Canada, conducted decades of research to determine whether intellectual disability predicts a low chance of remission and a high risk of intractability in epilepsy. Eligible participants were children from Nova Scotia, Canada, who developed epilepsy between 1977 and 1985 and had intellectual disability. The researchers followed the children for an average of 21 years following diagnosis. The initial study followed 692 children with incident epilepsy, of whom 147 (21%) had intellectual disability. The investigators administered standard psychometric testing when the children were approximately age 5 to establish the degree of intellectual disability, which was confirmed by subsequent academic achievements.
Among patients with epilepsy, the degree of intellectual disability is mild in approximately 25%, moderate in approximately 25%, and severe in approximately 50%. “In children with epilepsy, there is a large overrepresentation by those who have severe intellectual disability,” said Peter Camfield, MD, Professor Emeritus in the Department of Pediatrics at Dalhousie University.
Mild intellectual disability was associated with a substantially better prognosis for remission and absence of intractability than moderate or severe intellectual disability. Focal epilepsy with mild intellectual disability had the same rates of remission and intractability as focal epilepsy with normal intelligence. Although mild intellectual disability significantly affects social outcome, it is not an important prognostic factor for seizure outcome, particularly if the epilepsy is focal, said the researchers.
The level of intellectual disability varied by the type of epilepsy. Focal epilepsy was present in 70% of individuals with mild intellectual disability, 38% of patients with moderate intellectual disability and 29% of participants with severe intellectual disability. Generalized symptomatic epilepsies were more common among patients with moderate (53%) and severe (65%) intellectual disability than among patients with mild intellectual disability (13%). Participants with mild intellectual disability were more likely to be in remission at the end of the 20-year follow up (50%) than participants with moderate (34%) or severe (28%) intellectual disability. Intractable epilepsy was more common among subjects with moderate (35%) and severe (59%) intellectual disability than among people with mild intellectual disability (17%).
“Mild intellectual disability has a profound effect on a child’s adaptation to adult life,” said Dr. Camfield. “However, it is not particularly associated with severe epilepsy. Moderate to severe intellectual disability has ominous implications for seizure control.”
The study’s results “can be reassuring for families who have a child with mild intellectual disability that there’s still a very good chance that their epilepsy is going to settle and it won’t be too, too bad,” continued Dr. Camfield. “That’s important because those children, by definition, are mobile [and] will be in the community, so the concern about epilepsy control is probably greater than for the children with profound disability who are going to be under supervision all the time.”
—Erik Greb