The long term prognosis in 90 children with partial or generalized tonic-clonic seizures treated with CBZ has been evaluated in the Department of Pediatrics, Kyoto University, Kyoto, Japan. Sixty-seven (74%) treated with CBZ monotherapy were seizure free for more than three years. Fifty (56%) had no epileptiform discharge on the follow-up EEG. Patients with mental retardation and a genetic predisposition were more likely to have an abnormal EEG. The incidence of mental retardation was significantly higher in those treated with polytherapy. The prognosis of patients with partial seizures secondarily generalized was less favorable than that of the other patients. Patients without mental retardation more often received CBZ monotherapy and patients with seizures of undetermined etiology more often received polytherapy. The lowest blood level of CBZ for maintenance was 4 meg/ml and maximum blood levels ranged from 6-12 meg/ml. Side effects were observed in 20 patients who had drowsiness, 4 ataxia, 2 a rash and 1 had anorexia. The SGOT, SGPT, or both were elevated in 16 patients. Leukopenia between 2,000 and 4,000 occurred in 32 patients. [1]

COMMENT. There was no correlation between the type of seizure and the prognosis of the patients in this study. All patients with simple partial seizures and benign epilepsy of children with centrotemporal foci were seizure free for more than one year and the majority were seizure free for more than three years. There was no correlation between a history of febrile convulsions and the prognosis of children with partial or generalized tonic-clonic seizures. Patients with partial seizures secondarily generalized had a less favorable prognosis than that of other patients.