Purpose: Can some early seizures be the direct cause of developmental stagnation or regression? Does early treatment affect prognosis? Methods: In this clinical longitudinal study 105 selected patients were studied; their age ranged from 6 months to 6 years and they were followed up for 6 years. They were classified into 3 groups according to time of diagnosis and time of starting proper treatment, type of seizure, EEG and MRI pictures. Group 1 - 35 patients who were diagnosed and started treatment within 8 weeks of onset. Group 2 - 18 patients whose diagnosis and treatment was delayed for 8 weeks but proper treatment started before 24 weeks. Group 3 - 52 patient whose diagnosis and treatment was delayed for 24 weeks. EEG was done for diagnosis, then for follow up. MRI was also done for diagnosis and exclusion. Psychological and developmental assessment were done for diagnosis, then every 3-months. Results showed global improvement of mental faculties and near normal developmental progress in most of the early diagnosed and treated patients in whom seizures were controlled. Psychological and developmental assessment scores of Group 1 are better than those of Group 2, which are better than those of Group 3. Conclusion: There is a possible under-estimation of the number of children with developmental retardation, directly caused by a relatively hidden epilepsy.

(Egypt J. Neurol. Psychiat. Neurosurg., 2004, 41(2): 449-457).