title: Polyspike and waves do not predict generalized tonic-clonic seizures in childhood absence epilepsy.
abstract: About 40% of children with childhood absence epilepsy develop generalized tonic-clonic seizures. It is commonly held that polyspike-wave pattern on the electroencephalogram (EEG) can predict this development of generalized tonic-clonic seizures. However, there is no firm evidence in support of this proposition. To test this assumption, we used survival analysis and compared the incidence of generalized tonic-clonic seizures in 115 patients with childhood absence epilepsy having either isolated 3-Hz spike-wave or coexisting 3 Hz and polyspike-waves and other variables. There was no evidence that polyspike-waves predicted development of generalized tonic-clonic seizures in patients with childhood absence epilepsy. Later age of onset (> or =8 years) and family histories of generalized tonic-clonic seizures were the only independent predictors. These results have implications for counseling and in the choice of first-line antiepileptic drugs used for childhood absence epilepsy, especially if valproate is chosen based on the observation of polyspike-waves.
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
authors.forename: Esther
authors.initials: E
authors.lastname: Vierck
authors.forename: Ryan
authors.initials: R
authors.lastname: Cauley
authors.forename: Steven L
authors.initials: SL
authors.lastname: Kugler
authors.forename: David E
authors.initials: DE
authors.lastname: Mandelbaum
authors.forename: Deb K
authors.initials: DK
authors.lastname: Pal
authors.forename: Martina
authors.initials: M
authors.lastname: Durner
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D004569:Electroencephalography / Q000379:methods*; D004832:Epilepsy, Absence / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D004830:Epilepsy, Tonic-Clonic / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D005071:Evoked Potentials / Q000502:physiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D014635:Valproic Acid / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid
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