Absence epilepsy: early prognostic signs.
We have studied 124 children with typical absence epilepsy. The onset of symptoms was in 12% under 4 years, in 51% between 4-8 years and in 37% above 8 years. The F:M ratio was 2:1 in children under 4 years versus 1:1 above 8 years. Absences alone occurred in 82% and absences followed or preceded by generalized tonic-clonic seizures (GTCS) in 6.5% and 11%, respectively. Simple absences were not seen in children under 4 years and were more frequent (14%) in the 4-8 years age group. Family history was positive for epilepsy in 20% and febrile convulsion in 7%. Sixteen percent had a positive past history of febrile convulsions. All patients showed bilateral, synchronous spike-wave discharges from 2.5 to 4 c/s. Lateralized spikes, spike-slow wave complexes were found in 27%. Photosensitivity was present in 18% and was marked in 12%. Monotherapy with sodium valproate or ethosuximide (91% SV) was successful in 85% of patients with absences alone and 68% of the absences with GTCS. Only 2% were not fully controlled either on monotherapy or polytherapy. Treatment was withdrawn in 41 patients and 13 relapsed. We have identified four factors associated with relapses: (a) poor initial response to treatment, (b) lateralized focal EEG abnormality and/or marked photosensitivity, (c) the evolution to myoclonic epilepsy, and (d) early withdrawal of AED (< 3 years).
Department of Neurology, Children's Hospital Aghia Sophia, Athens, Greece.
A
A
Covanis
K
K
Skiadas
N
N
Loli
C
C
Lada
V
V
Theodorou
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D004522:Educational Status; D004569:Electroencephalography / Q000187:drug effects; D004832:Epilepsy, Absence / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D004830:Epilepsy, Tonic-Clonic / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D003294:Seizures, Febrile / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics