Classification of Partial Epilepsies According to the Symptomatology of Seizures: Practical Value and Prognostic Implications

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Abstract
Among 1000 outpatient epileptics, 596 cases of partial epilepsy (PE) were chosen, representing 62.9% of all cases classified according to the International Classification of epilepsies. Of these cases 54 (5.7% of those classifiable) that were affected by benign infantile epilepsy with rolandic spikes were not analyzed further. The remaining cases were divided into 3 groups based on the symptomatology of the seizures: partial elementary epilepsy (PEE), 102 cases (10.8%); partial complex epilepsy (PCE), 332 cases (35%); and partial secondarily generalized epilepsy (PSGE), 108 cases (11.4%). The 3 groups were compared according to the parameters that distinguish recognized epileptic syndromes, to see whether they constitute autonomous nosographic entities. Among the 3 groups, significant differences did not arise with regard to the incidence of single lesional etiological factors, the age of onset of the epilepsy, the neurological and psychological context and the general features of interictal EEG. PSGE differs significantly from the other 2 forms of the minor severity of the epilepsy at 1st examination and for its more favorable course: after at least 2 yr follow-up under treatment, the epilepsy appeared to be controlled in 60.6% of the cases with PSGE, in 31.6% of those with PEE and in 37.5% of those with PCE (P < 0.05). For those with PE, globally considered, only 3 parameters have a favorable prognostic value: the brief duration of the epilepsy at the 1st observation, the rarity of the seizures and the presence of only 1 type of seizure.