Clinical dissection of early onset absence epilepsy in children and prognostic implications. Issue 10 (27th August 2013)

• Record Type: Journal Article
• Authors: Agostinelli, Sergio; Accorsi, Patrizia; Beccaria, Francesca; Belcastro, Vincenzo; Canevini, Maria Paola; Capovilla, Giuseppe; Cappanera, Silvia; Bernardina, Bernardo Dalla; Darra, Francesca; Gaudio, Luigi Del; Elia, Maurizio; Falsaperla, Raffaele; Giordano, Lucio; Gobbi, Giuseppe; Minetti, Carlo; Nicita, Francesco; Parisi, Pasquale; Pavone, Piero; Pezzella, Marianna; Sesta, Michela; Spalice, Alberto; Striano, Salvatore; Tozzi, Elisabetta; Traverso, Monica; Vari, Stella; Vignoli, Aglaia; Zamponi, Nelia; Zara, Federico; Striano, Pasquale; Verrotti, Alberto; on behalf of the SINP (Società Italiana Neurologia Pediatrica) Collaborative Working Group;
• Is Part Of: Epilepsia. Volume 54:Issue 10(2013:Oct.)
• Page Start: 1761
• Page End: 1770
• Publication Date: 2013-08-27
• Subjects: Epilepsy -- Periodicals; 616.853
• DOI: 10.1111/epi.12341
• Languages: English
• ISSNs: 0013-9580

Abstract

<abstract abstract-type="main" id="epi12341-abs-0001"> <title>Summary</title> <sec id="epi12341-sec-0001" sec-type="section"> <title>Purpose</title> <p>To investigate whether patients with typical absence seizures (TAS) starting in the first 3 years of life, conformed to Panayiotopoulos's definition of childhood absence epilepsy (CAE), show different electroclinical course than those not fulfilling CAE criteria.</p> </sec> <sec id="epi12341-sec-0002" sec-type="section"> <title>Methods</title> <p>In this multicenter retrospective study, we choose a fixed duration follow‐up of 36 months to examine the electroclinical course of epilepsy in all children with TAS starting before 3 years of age. The probands who fulfilled Panayiotopoulos's criteria for CAE were classified as having pure early onset absence epilepsy (P‐EOAE), whereas those who did not as nonpure EOAE (NP‐EOAE). In addition, these two groups of patients were further stratified according to the number of antiepileptic drugs taken to obtain initial seizure control (mono‐, bi‐, and tritherapy).</p> </sec> <sec id="epi12341-sec-0003" sec-type="section"> <title>Key Findings</title> <p>Patients with P‐EOAE (n = 111) showed earlier initial seizure control (p = 0.030) and better seizure‐free survival curve (p = 0.004) than those with NP‐EOAE (n = 77). No mutation in <italic>SLC2A1</italic> gene or abnormal neuroimaging was observed in P‐EOAE. Among patients with NP‐EOAE, those receiving tritherapy showed increased risk of structural brain abnormalities (p = 0.001) or <italic>SLC2A1</italic> mutations (p = 0.001) but fewer myoclonic features (p = 0.031) and worse seizure‐free survival curve (p = 0.047) than those treated with mono‐ and bitherapy. Children with NP‐EOAE had 2.134 the odds of having relapse during the follow‐up compare to those with P‐EOAE.</p> </sec> <sec id="epi12341-sec-0004" sec-type="section"> <title>Significance</title> <p>Children with early onset TAS who did meet Panayiotopoulos's criteria showed a favorable course of epilepsy, whereas patients not fulfilling Panayiotopoulos's criteria showed increased risk of relapse at long‐term follow‐up.</p> </sec> </abstract>