Long-term prognosis of childhood absence epilepsy.
BACKGROUND
Childhood absence epilepsy (CAE) is considered easily manageable with medication provided that a strict patient classification system is employed. It accounts for 10% of all childhood epilepsy cases starting before the age of 15 and it is most frequent in school-aged girls. The aim of this study is to analyse long-term outcomes of patients diagnosed with CAE according to the Loiseau and Panayiotopoulos criteria and treated during childhood.


METHODS
We conducted a retrospective study including 69 patients with CAE who are currently older than 11; data were gathered from medical histories, EEG records, and telephone questionnaires.


RESULTS
52 patients met the Loiseau and Panayiotopoulos criteria. Mean age is now 17.16 years. Female-to-male ratio was 1.65:1; mean age at onset was 6 years and 2 months; mean duration of treatment was 3 years and 9 months. A family history of epilepsy was present in 30.8% of the patients and 7.7% had a personal history of febrile convulsions. Absence seizures were simple in 73.5% of the patients and complex in 26.5%. Response rates to first-line treatment were as follows: valproic acid, 46.3%; and valproic acid plus ethosuximide, 90.9%. The rate of response to second-line therapy (ethosuximide or lamotrigine) was 84.2%; 4% of the patients experienced further seizures after treatment discontinuation, 78.8% achieved seizure remission, and 25% needed psychological and academic support.


CONCLUSIONS
Our data show that epileptic patients should be classified according to strict diagnostic criteria since patients with true CAE have an excellent prognosis. The relapse rate was very low in our sample. Despite the favourable prognosis, psychological and academic support is usually necessary.
Sección Neuropediatría, Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España. Electronic address: martinezferrandez@gmail.com.
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Martínez-Ferrández
Sección Neuropediatría, Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
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Martínez-Salcedo
Sección Neuropediatría, Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
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Casas-Fernández
Sección Neuropediatría, Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
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Alarcón-Martínez
Sección Neuropediatría, Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
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Ibáñez-Micó
Sección Neuropediatría, Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
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Domingo-Jiménez
D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D018450:Disease Progression; D004832:Epilepsy, Absence / Q000175:diagnosis* / Q000188:drug therapy; D005013:Ethosuximide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use
D000927:Anticonvulsants; D005013:Ethosuximide; D014635:Valproic Acid
Childhood absence epilepsy; Epilepsia; Epilepsia ausencia infantil; Epilepsia generalizada idiopática; Epilepsy; Epilepsy treatment; Idiopathic generalised epilepsy; Prognosis; Pronóstico; Tratamiento de la epilepsia