[Effect of cerebral organic changes on the age of manifestation of childhood epilepsy].

In the present study, the influence of organic alterations in the brain on the age of manifestation of epilepsy was investigated by means of cranial computer tomography (CCT) in 307 children and adolescents. 38% of these patients revealed abnormal morphological findings in the CCT. Whereas in children with primary generalized and partial epilepsy the vast majority (80% and 75% respectively) showed normal findings, this only applied to barely half of the patients with secondary generalized epilepsy. The pathological CCT findings were characterized mainly by diffuse alterations in primary generalized epilepsy. On the other hand, children with secondary generalized epilepsy showed above-average focal defects. The age of onset of the disease showed a close relation with the CCT findings. In patients with pathological CCT alterations, the epilepsy was manifested very much earlier than in the reference group. However, the special features of the age distribution in relation to the CCT findings only applied to secondary generalized epilepsy. Thus 80% of the diseases in the first year of life involved this form of epilepsy (in the vast majority, West syndrome), in which pathological CCT alterations were present almost without exception. These results made it evident that exogenous factors have a crucial effect on the age of manifestation, the clinical features and course of epilepsy.