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The outcome of absence epilepsy

A meta-analysis

From the Departments of Neurology (Drs. Bouma, van Dijk, and Brouwer) and Clinical Epidemiology (Dr. Westendorp), Leiden University Hospital, Leiden; and the Department of Child Neurology (Dr. Peters), University Hospital Utrecht and Wilhelmina Children's Hospital, Utrecht; The Netherlands.
Received November 30, 1995. Accepted in final form February 5, 1996.
Address correspondence and reprint requests to P.A.D. Bouma, Department of Neurology, Leiden University Hospital, P.O. Box 9600, 2300 RC Leiden, The Netherlands.

We performed a meta-analysis of studies on absence epilepsy (AE) to ascertain whether the outcome of this well-defined type of epilepsy can be stated unequivocally. Using the Index Medicus and Medline CD+, we identified 1,619 publications. After applying the criteria of the International League against Epilepsy (ILAE) for AE, 26 publications on 23 study cohorts with a total of 2,303 patients were included. Remission rates ranged from 0.21 to 0.89; they differed substantially due to heterogeneity between the studies in inclusion criteria, methods, follow-up length, and outcome definitions. One half of the patients developed generalized tonic-clonic seizures (TCS) in the course of the disease. The proportion seizure free was 0.78 for patients with absence seizures (AS) only, and 0.35 for those who developed TCS. The outcome of AE may be worse than previously stated due to the considerable proportion of patients developing TCS in the course of their disease. Early prediction of outcome in patients who present with AS cannot be provided with certainty.

NEUROLOGY 1996;47: 802-808

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