A population-based study of long-term outcomes of cryptogenic @entity1625 in childhood: cryptogenic @entity302 is probably not symptomatic XXXX .

@entity1 @entity410 @entity1625 @entity302
PURPOSE: To compare long-term outcome in a population-based group of @entity1 with cryptogenic versus symptomatic @entity1625 diagnosed from 1980 to 2004 and to define the course of @entity302 in the cryptogenic group. METHODS: We identified all @entity1 residing in Olmsted County, MN, 1 month through 17 years, with newly diagnosed, @entity1625 from 1980 to 2004. @entity1 with idiopathic @entity302 were excluded. Medical records were reviewed to determine etiology, results of imaging and EEG studies, treatments used, and long-term outcome. @entity1 were defined as having symptomatic @entity302 if they had a known genetic or structural/metabolic etiology, and as cryptogenic if they did not. KEY FINDINGS: Of 359 @entity1 with newly diagnosed @entity302 , 215 (60%) had @entity1625 . Of these, 206 (96%) were followed for > 12 months. Ninety-five @entity1 (46%) were classified as symptomatic. Median follow-up from diagnosis was similar in both groups, being 157 months (25%, 75%: 89, 233) in the cryptogenic group versus 134 months (25%, 75%: 78, 220) in the symptomatic group (p = 0.26). Of 111 cryptogenic cases, 66% had normal cognition. Long-term outcome was significantly better in those with cryptogenic versus symptomatic etiology (intractable @entity302 at last follow-up, 7% vs. 40%, p < 0.001; @entity410 freedom at last follow-up, 81% vs. 55%, p < 0.001). Of those who achieved @entity410 freedom at final follow-up, 68% of the cryptogenic group versus only 46% of the symptomatic group were off antiepileptic medications (p = 0.01). One-third of the cryptogenic group had a remarkably benign disorder, with no @entity410 seen after initiation of medication, or in those who were untreated, after the second @entity410 . A further 5% had @entity410 within the first year but remained @entity410 -free thereafter. With the exception of perinatal complications, which predicted against @entity410 remission, no other factors were found to significantly predict outcome in the cryptogenic group. SIGNIFICANCE: More than half of childhood nonidiopathic localization-related @entity302 is cryptogenic. This group has a significantly better long-term outcome than those with a symptomatic etiology, and should be distinguished from it.
