title: Therapeutic Outcomes and Prognostic Factors in Childhood Absence Epilepsy.
abstract: OBJECTIVE
  Childhood absence epilepsy (CAE) is one of the most common types of pediatric epilepsy. It is generally treated with ethosuximide (ESM), valproic acid (VPA), or lamotrigine (LTG), but the efficacy and adverse effects of these drugs remain controversial. This study compared initial therapy treatment outcomes, including VPA-LTG combination, and assessed clinical factors that may predict treatment response and prognosis.
  
  
  METHODS
  Sixty-seven patients with typical CAE were retrospectively enrolled at the Korea University Medical Center. We reviewed patients' clinical characteristics, including age of seizure onset, seizure-free interval, duration of seizure-free period, freedom from treatment failure, breakthrough seizures frequency, and electroencephalogram (EEG) findings.
  
  
  RESULTS
  The age at seizure onset was 7.9±2.7 years (mean±SD), and follow-up duration was 4.4±3.7 years. Initially, 22 children were treated with ESM (32.8%), 23 with VPA (34.3%), 14 with LTG (20.9%), and 8 with VPA-LTG combination (11.9%). After 48 months of therapy, the rate of freedom from treatment failure was significantly higher for the VPA-LTG combination therapy than in the three monotherapy groups (p=0.012). The treatment dose administrated in the VPA-LTG combination group was less than that in the VPA and LTG monotherapy groups. The shorter interval to loss of 3-Hz spike-and-wave complexes and the presence of occipital intermittent rhythmic delta activity on EEG were significant factors predicting good treatment response.
  
  
  CONCLUSIONS
  This study showed that low-dose VPA-LTG combination therapy has a good efficacy and fewer side effects than other treatments, and it should thus be considered as a firstline therapy in absence epilepsy.
authors.affiliation: Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Hye Ryun
authors.initials: HR
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Gun Ha
authors.initials: GH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea.
authors.forename: So Hee
authors.initials: SH
authors.lastname: Eun
authors.affiliation: Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Baik Lin
authors.initials: BL
authors.lastname: Eun
authors.affiliation: Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea. byeonagnes@naver.com.
authors.forename: Jung Hye
authors.initials: JH
authors.lastname: Byeon
keywords: absence seizures; epilepsy; lamotrigine; prognostic factors; valproic acid