title: Temporal current-source of spikes suggests initial treatment failure in childhood absence epilepsy.
abstract: OBJECTIVE
  In addition to the frontal lobe, the temporal lobe may also be involved in typical absence seizures. However, few studies have addressed the relationship between this involvement and drug responsiveness in childhood absence epilepsy (CAE). In this study, we observed the current-source distribution (CSD) of generalized spike-and-wave discharges (GSWDs) and investigated the relationship between temporal lobe involvement in the CSD and responsiveness to initial antiepileptic drug (AED) in CAE.
  
  
  METHODS
  Seventeen consecutive patients with CAE were retrospectively enrolled in the study. Patients were divided into an initial-response group and an initial-failure group, according to their responsiveness to the initial AED treatment. For each patient, the spike peak CSD of an averaged GSWD was obtained from the initial electroencephalogram. We compared the incidence of temporal involvement in the CSD between the two groups. We also compared clinical variables, including age of onset, gender, type and dose of first AED, time to cessation of clinical seizures, and seizure-free status.
  
  
  RESULTS
  The initial-response and initial-failure groups contained 12 and five patients, respectively. Temporal lobe involvement was more frequent (80% vs. 17%, p = 0.03), and time to cessation of clinical seizures was more prolonged (median 2.5 months vs. 8 months, p<0.01) in the initial-failure than in the initial-response group. None of the other variables studied differed between groups.
  
  
  CONCLUSIONS
  Initial AED failure was associated with temporal involvement in the CSD of CAE patients. This electrophysiological information may be helpful in clinical practice by estimating the efficacy of initial AED treatment in AED-naïve CAE patients in advance.
authors.affiliation: Department of Pediatrics, Gyengsang National University School of Medicine, Jinju, Republic of Korea; Gyeongsang Institute of Health Science, Jinju, Republic of Korea.
authors.forename: Jung Sook
authors.initials: JS
authors.lastname: Yeom
authors.affiliation: Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University, Changwon, Republic of Korea.
authors.forename: Young-Soo
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University, Changwon, Republic of Korea.
authors.forename: Jun Hwa
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Neurology, Gyengsang National University School of Medicine, Jinju, Republic of Korea.
authors.forename: Seokwon
authors.initials: S
authors.lastname: Jung
authors.affiliation: Gyeongsang Institute of Health Science, Jinju, Republic of Korea; Department of Neurology, Gyengsang National University School of Medicine, Jinju, Republic of Korea. Electronic address: mnkwon21@daum.net.
authors.forename: Oh-Young
authors.initials: OY
authors.lastname: Kwon
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D000069279:Drug Resistant Epilepsy / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D004569:Electroencephalography; D004832:Epilepsy, Absence / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D012815:Signal Processing, Computer-Assisted; D013702:Temporal Lobe / Q000503:physiopathology; D017211:Treatment Failure
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic drugs; Childhood absence epilepsy; Current-source analysis; Electroencephalography