Emilio Franzoni1, Sara Matricardi2, Veronica Di Pisa3, Giuseppe Capovilla4, Antonino Romeo5, Elisabetta Tozzi6, Dario Pruna7, Grazia Gabriella Salerno8, Nelia Zamponi8, Patrizia Accorsi9, Lucio Giordano9, Giangennaro Coppola10, Caterina Cerminara11, Paolo Curatolo11, Francesco Nicita12, Alberto Spalice12, Salvatore Grosso13, Piero Pavone14, Pasquale Striano15, Pasquale Parisi16, Antonella Boni17, Giuseppe Gobbi17, Marco Carotenuto18, Maria Esposito18, Carlo Cottone3, Alberto Verrotti19. 1. Child Neuropsychiatry Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: emilio.franzoni@unibo.it. 2. Department of Pediatrics, University of Chieti, Chieti, Italy. 3. Child Neuropsychiatry Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. 4. Department of Child Neuropsychiatry, C. Poma Hospital, Mantova, Italy. 5. Epilepsy Center, Department of Child Neuropsychiatry and Neurophysiology, Fatebenefratelli and Oftalmico Hospital, Milan, Italy. 6. Department of Child Neuropsychiatry, University of L'Aquila, L'Aquila, Italy. 7. Child and Adolescent Neuropsychiatry, University of Cagliari, Cagliari, Italy. 8. Pediatric Neurology Department, Polytechnic University of the Marche Region, Ancona, Italy. 9. Child Neuropsychiatric Unit, Civile Hospital, Brescia, Italy. 10. Department of Child and Adolescent Neuropsychiatric, Medical School, University of Salerno, Salerno, Italy. 11. Department of Neurosciences, Pediatric Neurology Unit, Tor Vergata University, Roma, Italy. 12. Department of Pediatrics, Division of Child Neurology, Sapienza, University of Rome, Rome, Italy. 13. Department of Pediatrics, Pediatric Neurology Unit, S. Maria Alle Scotte Hospital, University of Siena, Italy. 14. Department of Pediatrics and Pediatrics Emergency, University Hospital Policlinico Vittorio Emanuele, Catania, Italy. 15. Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Opthalmology, Genetics and Maternal and Child Health, University of Genova, G. Gaslini Institute, Genova, Italy. 16. Neuroscience, Mental Health and Sensory Organs Department, Child Neurology, Headache Pediatric Center, Pediatric Sleep Disorder, Sapienza, University of Rome, Rome, Italy. 17. IRRCS, The Institute of Neurological Sciences of Bologna, Child Neurology Unit, Bologna, Italy. 18. Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy. 19. Department of Pediatrics, University of Perugia, Perugia, Italy.
Abstract
BACKGROUND: To evaluate evidence and prognosis of refractory cases of absence seizures. METHODS: Subjects with refractory absence seizures were identified retrospectively in 17 Italian epilepsy pediatrics Centers. We analyzed age at onset, family history, presence of myoclonic components, seizure frequency, treatment with antiepileptic drugs (AEDs), interictal electroencephalography (EEG) and neuropsychological assessment. Two subgroups were identified: one with patients with current absence seizures and another with patients that had become seizure free with or without AED treatment. The chi-square test was applied. RESULTS: A total of 92 subjects with drug-resistant absence seizures were analyzed. 45 subjects still show absence seizures (49%) and the other 47 became seizure free (51%) after a period of drug-resistance. The statistical analysis between these two groups showed no correlation between age of onset, family history and abnormalities at interictal EEG. Statistically significant differences were observed with regard to the number of AEDs used and intellectual disability. CONCLUSION: Typical absence epilepsy classifiable as Childhood Absence Epilepsy could not be considered so "benign", as suggested in literature. A longer duration of disease and a higher frequency of seizure seem to be correlated with a higher presence of cognitive impairment. No significant risk factor was observed to allow the faster and better recognition of patients with worse prognosis.
BACKGROUND: To evaluate evidence and prognosis of refractory cases of absence seizures. METHODS: Subjects with refractory absence seizures were identified retrospectively in 17 Italian epilepsy pediatrics Centers. We analyzed age at onset, family history, presence of myoclonic components, seizure frequency, treatment with antiepileptic drugs (AEDs), interictal electroencephalography (EEG) and neuropsychological assessment. Two subgroups were identified: one with patients with current absence seizures and another with patients that had become seizure free with or without AED treatment. The chi-square test was applied. RESULTS: A total of 92 subjects with drug-resistant absence seizures were analyzed. 45 subjects still show absence seizures (49%) and the other 47 became seizure free (51%) after a period of drug-resistance. The statistical analysis between these two groups showed no correlation between age of onset, family history and abnormalities at interictal EEG. Statistically significant differences were observed with regard to the number of AEDs used and intellectual disability. CONCLUSION: Typical absence epilepsy classifiable as Childhood Absence Epilepsy could not be considered so "benign", as suggested in literature. A longer duration of disease and a higher frequency of seizure seem to be correlated with a higher presence of cognitive impairment. No significant risk factor was observed to allow the faster and better recognition of patients with worse prognosis.
Authors: Eric L A Fonseca Wald; Jos G M Hendriksen; Gerald S Drenthen; Sander M J V Kuijk; Albert P Aldenkamp; Johan S H Vles; R Jeroen Vermeulen; Mariette H J A Debeij-van Hall; Sylvia Klinkenberg Journal: Neuropsychol Rev Date: 2019-11-27 Impact factor: 7.444