Prognostic factors for epileptic seizures in severe motor and intellectual disabilities syndrome (SMIDS)—A clinical and electroencephalographic study

• Published in: Epilepsy Research Vol. 86; no. 2; pp. 175 - 182
• Main Authors: Matsumoto, Akiko, Miyazaki, Shuji, Hayakawa, Chiemi, Komori, Taku, Nakamura, Miho, Oshio, Atsushi
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier B.V 01.10.2009; Elsevier BV; Elsevier
• Subjects: Adolescent; Adult; Anticonvulsants. Antiepileptics. Antiparkinson agents; Biological and medical sciences; Brain Mapping; Child; Child, Preschool; Developmental Disabilities; Developmental Disabilities - diagnosis; Electroencephalography; Epilepsy; Epilepsy - diagnosis; Epileptic syndrome; Factor analysis; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Intellectual Disability; Intellectual Disability - diagnosis; Male; Medical sciences; Middle Aged; Movement Disorders; Movement Disorders - diagnosis; Nervous system (semeiology, syndromes); Neurology; Neuropharmacology; Patient Selection; Pharmacology. Drug treatments; Prognosis; Prognostic factor; Quality of Life; Severity of Illness Index; SMIDS; Syndrome; Prognostic factor; Electroencephalography; Factor analysis; SMIDS; Epileptic syndrome; Epilepsy; Handicap; Nervous system diseases; Prognosis; Electrophysiology; Developmental disorder; Mental retardation; Epileptic seizure; Cerebral disorder; Central nervous system disease; Intellectual deficiency
• ISSN: 0920-1211; 1872-6844; 1872-6844
• DOI: 10.1016/j.eplepsyres.2009.06.005

The purpose of this study is to examine prognostic factors for seizures in 106 epileptic patients with SMIDS. One-hundred-six epileptic patients with SMIDS were the subjects of this study. The study group consisted of 60 male and 46 female patients. The ages ranged from 4 to 61 years. They were all followed up for more than 4 years in our residential facility hospital “Kobato Gakuen”. Fourteen possible prognostic factors were investigated statistically, and the validity is studied by factor analysis (principal component method). Statistically significant poor prognostic factors for epileptic seizures in SMIDS were (1) status epilepticus; (2) multifocal spikes (MFS) or Diffuse spike and waves (DSW) on final EEG; (3) symptomatic generalized epilepsy; (4) MFS or DSW on first EEG; (5) multi-antiepileptic drugs; (6) postnatal etiology; and (7) short duration of institutional hospitalization. As a result of factor analysis, the following five factors are elucidated: (1) Age/Time Passage; (2) Status epilepticus/Etiology; (3) Epileptic syndrome/EEG; (4) intensive medical care; and (5) Severity of Disabilities/Gender. Our findings indicate that intractability of epilepsy may be identified early in the course of the disease, even in SMIDS, and EEG and epileptic syndrome are the very important factors for predicting the seizure prognosis.