although, as indicated above, there is a slight risk of developing
epilepsy later on in life. Death or persistent motor deficit
following simple seizures is unusual. Intellectual deficits occur
rarely and are more likely for children with pre-existing
neurological or developmental abnormalities, and those who
developed subsequent afebrile seizures.
The prognosis of children with epilepsy is generally
good. In children whose anticonvulsant therapy has
been withdrawn after prolonged control, about 30% will
experience recurrence of seizures. Of these, 85% will relapse
within 5 years of drug withdrawal. Factors associated with
higher risk of relapse are:
■■Long duration of epilepsy before control
■■Pre-existing neurological deficits
■■Abnormal EEG before anticonvulsants were discontinued
■■Early onset of seizure below 2 years of age.
In conclusion, the neurologically normal child with epilepsy
who has had not many seizures before control and whose
EEG is normal or slightly abnormal is at low risk of seizure
recurrence on stopping medications after 2 years.