title: Refractory absence seizures: An Italian multicenter retrospective study.
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.
  
  
  CONCLUSIONS
  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.affiliation: Child Neuropsychiatry Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: emilio.franzoni@unibo.it.
authors.forename: Emilio
authors.initials: E
authors.lastname: Franzoni
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Matricardi
authors.affiliation: Child Neuropsychiatry Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Di Pisa
authors.affiliation: Department of Child Neuropsychiatry, C. Poma Hospital, Mantova, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Capovilla
authors.affiliation: Epilepsy Center, Department of Child Neuropsychiatry and Neurophysiology, Fatebenefratelli and Oftalmico Hospital, Milan, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Romeo
authors.affiliation: Department of Child Neuropsychiatry, University of L'Aquila, L'Aquila, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Tozzi
authors.affiliation: Child and Adolescent Neuropsychiatry, University of Cagliari, Cagliari, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Pruna
authors.affiliation: Pediatric Neurology Department, Polytechnic University of the Marche Region, Ancona, Italy.
authors.forename: Grazia Gabriella
authors.initials: GG
authors.lastname: Salerno
authors.affiliation: Pediatric Neurology Department, Polytechnic University of the Marche Region, Ancona, Italy.
authors.forename: Nelia
authors.initials: N
authors.lastname: Zamponi
authors.affiliation: Child Neuropsychiatric Unit, Civile Hospital, Brescia, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Accorsi
authors.affiliation: Child Neuropsychiatric Unit, Civile Hospital, Brescia, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Giordano
authors.affiliation: Department of Child and Adolescent Neuropsychiatric, Medical School, University of Salerno, Salerno, Italy.
authors.forename: Giangennaro
authors.initials: G
authors.lastname: Coppola
authors.affiliation: Department of Neurosciences, Pediatric Neurology Unit, Tor Vergata University, Roma, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Cerminara
authors.affiliation: Department of Neurosciences, Pediatric Neurology Unit, Tor Vergata University, Roma, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Curatolo
authors.affiliation: Department of Pediatrics, Division of Child Neurology, Sapienza, University of Rome, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Nicita
authors.affiliation: Department of Pediatrics, Division of Child Neurology, Sapienza, University of Rome, Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Spalice
authors.affiliation: Department of Pediatrics, Pediatric Neurology Unit, S. Maria Alle Scotte Hospital, University of Siena, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Grosso
authors.affiliation: Department of Pediatrics and Pediatrics Emergency, University Hospital Policlinico Vittorio Emanuele, Catania, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Pavone
authors.affiliation: 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.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Striano
authors.affiliation: Neuroscience, Mental Health and Sensory Organs Department, Child Neurology, Headache Pediatric Center, Pediatric Sleep Disorder, Sapienza, University of Rome, Rome, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Parisi
authors.affiliation: IRRCS, The Institute of Neurological Sciences of Bologna, Child Neurology Unit, Bologna, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Boni
authors.affiliation: IRRCS, The Institute of Neurological Sciences of Bologna, Child Neurology Unit, Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gobbi
authors.affiliation: Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Carotenuto
authors.affiliation: Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Esposito
authors.affiliation: Child Neuropsychiatry Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Cottone
authors.affiliation: Department of Pediatrics, University of Perugia, Perugia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Verrotti
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D004569:Electroencephalography; D004832:Epilepsy, Absence / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology* / Q000209:etiology*; D007558:Italy; D008297:Male; D009483:Neuropsychological Tests; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Childhood absence epilepsy; Drug-resistance; Idiopathic generalized epilepsy; Neuropsychological deficits