The prognosis – Is it curable?
The concept of cure in the treatment of epilepsy first needs a more precise definition. In this context, a cure can be understood as a fundamental elimination of the underlying cause, but also as freedom from symptoms, in the sense of successful suppression of seizures. The former is only possible in very few cases, namely when surgical intervention is possible in the child and the triggering group of nerve cells, called the focus of epilepsy, has been removed.
However, this can take on large proportions, so that in rare cases an entire hemisphere of the brain has to be removed. A seizure-free state can usually be achieved by using individual antiepileptic drugs or a combination of these. By definition, epilepsy is also considered cured if a patient has been seizure-free for more than 2 years without treatment.
However, it is unclear to what extent the therapy or other treatments that have been carried out have an influence on this development. For childhood epilepsies it must also be mentioned that, as described above, they are in many cases self-limiting and disappear at the end of childhood and adolescence. After 2 years, there is then also talk of a cure here.
What could be the long-term consequences?
In many forms of epilepsy in childhood, no long-term consequences are to be expected, as is the case with Rolando’s epilepsy, for example. However, several syndromes have also been described which lead to a high proportion of children showing a delay in development. This can take on slight proportions and only lead to a slightly delayed attainment of the developmental stages, but also to massive limitations in intelligence that can last for the rest of life. In order to prevent this development, attempts are made to identify and treat these forms of epilepsy as early as possible, but it is unclear whether this has a strong influence on the course of the disease.
