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Grand mal Epilepsis in Childhood: Clinical and Electroencephalographic Studies

Clinical and electroencephalographic investigations including long-term follow-up study for a period of more than 5 years were carried out systematically on 427 cases of childhood epilepsy showing only the grand ma1 seizures in their course. Particular attentions were paid on factors influencing the course and prognosis in these cases. The results are as follows: 1) The benign group in which seizure was immediately suppressed by the administration of only one antiepileptic drug consisted of 176 cases (41.2%). The malignant group in which seizure continued to occur for more than 5 years included only 13 cases (3.0%). The intermediate group consisted of 238 cases (55.8%). 2) No particular correlation was found between age of the onset or presumptive causes of the disease and prognosis except for the fact that the malignant group had many late onset cases, the onset being later than 10 years old. Underlying diseases such as the mental deficiency and the cerebral palsy were observed in a few cases among the benign group and in more cases in the malignant group. 4) Examination of correlations between occurrence of seizures and the sleep-waking cycle indicated that the “diffuse” type appeared frequently in the malignant group, while the “awakening” type and the “sleeping” type, especially the former, were observed most often in the benign group. All cases which manifested the seizure only in the febrile state belonged to the benign group, not to the malignant group. 6) It was indicated electroencephalo3)