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It is nowadays well-established that a large number of patients with epilepsy can experience a full remission of their condition. In some cases, seizures that were resistant at the onset of the disease may become responsive to therapy over the years. A good knowledge of the classification of epilepsies and epileptic syndromes may give important clues to the overall prognosis of particular epilepsy case. In subjects controlled by therapy, a slow and careful discontinuance of drugs may be initiated after a 2-year seizure-free period. If seizures recur, it will most probably be possible to return to full control with a lesser treatment. Even if seizures fail to be totally controlled and therapy cannot be discontinued, it is often possible to reduce polypharmacy and thus lessen unwanted side-effects.

Thirty-four epileptic patients, aged 9 to 36, were submitted to A/EEG between May 1987 and July 1988. All patients had a thorough clinical and EEG work-up including long-term conventional EEG, afternoon polygraphic sleep recording and, in some cases, full-night EEG and video monitoring. Patients were divided into 2 groups: group I included 19 patients (18 with symptomatic partial epilepsy (SPE) and 1 with idiopathic generalized epilepsy (IGE) in whom no seizure had ever been recorded in spite of EEG recordings averaging a total of 16 hrs 10 min, awake and asleep); group II included 15 subjects (6 with SPE, 5 with IGE, 3 with symptomatic GE and 1 with undetermined epilepsy) in whom one or several seizures had been recorded. A/EEG was performed in order to: 1) obtain better clinical and EEG characterization of seizures, 2) study the circadian distribution of seizures, 3) verify the efficacy of drug treatment and, 4) establish the epileptic or non-epileptic nature of some ictal events. The results of A/EEG were considered positive in 52.63% of group I patients and in 93.33% of group II patients. The authors discuss the specific advantages of A/EEG vs conventional EEG: recording of seizures with random occurrence, of seizures accompanied by falls, checking the remission of seizures.