Epilepsy - Outlook and Effects

Survival Rates

Epileptic patients who are cured have a normal lifespan. Their long-term survival rates are lower than average, however, if medications or surgery fail to stop the seizures. The lower survival rate is partly due to a higher-than-average risk for death due to accidents and suicide. The specific cause of the seizure may also contribute to fatalities.

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There is a very low risk for sudden death in patients with epilepsy. Although the causes of such events are not fully known, experts suspect heart arrhythmias in many cases. There is some evidence, in fact, that a malfunction in the autonomic nervous system (which controls heart rate) may be responsible for some of these deaths. Some researchers believe that temporal lobe surgery in appropriate patients may reduce the risk. Drugs that block arrhythmias may also be helpful in reducing this risk.

Effects of Epilepsy in Children

Chance for Recurrence After a First Seizure. According to one 2000 study, about 64% children with one seizure unrelated to fevers have another one, and nearly two-thirds who have a history of more than one seizure are likely to have more seizures. Researchers are trying to find ways of predicting which children have the best chances to become seizure free, and which ones will not. Studies suggest that the frequency of early seizures, not their total number or type, determines whether a child will develop intractable epilepsy.

Long-Term General Effects. In general, the long-term effects of seizures vary widely depending on the seizure's cause. Children with febrile seizures rarely have any long-term effects. In very rare cases, children experience severe fever-related seizures known as complex febrile convulsions. In such cases, there is a risk for brain injury that may lead to temporal lobe epilepsy, but this is very small. Such seizures last over 15 minutes, occur more than once within 24 hours, and may affect only one side of the body.

The long-term outlook for children with idiopathic epilepsy (epilepsy of unknown causes) is very favorable. One study reported that between 68% and 92% of such individuals were seizure-free after 20 years. In addition, a 2000 study reported that they had a survival rate no different from children without these seizures.

Children whose epilepsy is a result of a specific condition (for example, a head injury or neurologic disorder) have higher mortality rates than the normal population, but their lower survival rates are most often due to the underlying condition not the epilepsy itself.