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Sonoda Y, Sanefuji M, Ichimiya Y, Torio M, Watanabe E, Sakata A, Ishizaki Y, Sakai Y, Ohga S. Age-related morphological differences in the spike-and-wave complexes of absence epilepsy. Epilepsy Res 2021; 174:106647. [PMID: 33915304 DOI: 10.1016/j.eplepsyres.2021.106647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/29/2021] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Absence epilepsy shows age-related clinical features, as is observed in childhood and juvenile absence epilepsy. Electroencephalogram (EEG) is characterized by bursts of 3 Hz spike-and-wave complex (SWC). We noticed a morphological variation of the slow-wave component of SWCs between patients. This study investigated whether the waveform of SWC might be associated with the child's age of this epilepsy. METHODS Digitally-recorded EEGs under medication-free conditions were collected from 25 children who received the diagnosis of childhood or juvenile absence epilepsy. The morphology of slow wave in SWC in the frontal midline region was quantitatively compared between younger and older children using a cluster-based permutation test. RESULTS At <7 years of age (2.9-6.5 years of age, n = 6), the electrical potential of the descending slope in the slow wave was positively correlated with age whereas this correlation was not observed in patients of ≥7 years of age (7.1-12.9 years, n = 19). A cluster-based permutation test confirmed the results-among the entire slow wave period (0-285 msec), the period of the descending slope (195-260 msec) showed significantly lower potential in patients of <7 years of age in comparison to patients of ≥7 years of age (sum of t-values: 46.57, p-value: 0.011). CONCLUSIONS The current study demonstrated an age-dependent morphological difference in the slow-wave components of SWCs in EEGs of patients with pediatric absence epilepsy. This finding may provide a clue to understanding the age-related clinical manifestations of this epilepsy.
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Affiliation(s)
- Yuri Sonoda
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan; Research Center for Environment and Developmental Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Masafumi Sanefuji
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan; Research Center for Environment and Developmental Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Yuko Ichimiya
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Michiko Torio
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Eriko Watanabe
- Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Ayumi Sakata
- Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yoshito Ishizaki
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan; Department of Pediatrics, Fukuoka Higashi Medical Center, 1-1-1 Chidori, Koga, Fukuoka, 811-3195, Japan
| | - Yasunari Sakai
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Ossenblok P, van Houdt P, Colon A, Stroink H, van Luijtelaar G. A network approach to investigate the bi-hemispheric synchrony in absence epilepsy. Clin Neurophysiol 2019; 130:1611-1619. [PMID: 31319290 DOI: 10.1016/j.clinph.2019.05.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/11/2019] [Accepted: 05/22/2019] [Indexed: 11/24/2022]
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Yang Z, Xue J, Li H, Qian P, Liu X, Jiang Y, Zhang Y. Early childhood myoclonic epilepsy: An independent genetic generalized epilepsy with myoclonic seizures as the main seizure type. Clin Neurophysiol 2017; 128:1656-1663. [PMID: 28738275 DOI: 10.1016/j.clinph.2017.06.244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/21/2017] [Accepted: 06/14/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To elucidate the characteristics of the myoclonic seizures alone, or predominant myoclonus combined with generalized tonic-clonic seizures (GTCS) and/or absences, in early childhood, and discuss its classification. METHODS Forty-two children were retrospectively recruited between January 2006 and June 2015. RESULTS The mean age of seizure onset was 40.5months. They were divided into 4 groups: myoclonic seizures alone; predominant myoclonus combined with GTCS; predominant myoclonus combined with absences; predominant myoclonus combined with both GTCS and absences. Interictal EEG showed generalized spike- or polyspike-wave discharges at 2-4Hz. Seizures were controlled in 22 patients at a mean age of 60.5months. The psychomotor development was normal (30/37) or mildly delayed (7/37). CONCLUSIONS We reported a cohort of patients with early childhood myoclonic epilepsy (ECME), with the following characteristics: Seizures started below 5years old in otherwise normal children; Seizure types included myoclonic seizures alone or combined with GTCS and/or absences; Febrile or afebrile GTCS might appear firstly; Interictal EEG showed generalized spike- or polyspike-wave; Seizures usually were in remission before adolescence with normal development or mild cognitive or behavioral deficits in most. SIGNIFICANCE ECME might be an independent epileptic syndrome not established by International League Against Epilepsy (ILAE) previously.
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Affiliation(s)
- Zhixian Yang
- Department of Pediatrics, Peking University First Hospital, Beijing, China.
| | - Jiao Xue
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Hui Li
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Ping Qian
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Xiaoyan Liu
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yuwu Jiang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Yuehua Zhang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
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Giordano L, Vignoli A, Cusmai R, Parisi P, Mastrangelo M, Coppola G, Cordelli DM, Accorsi P, Milito G, Darra F, Pruna D, Belcastro V, Verrotti A, Striano P. Early onset absence epilepsy with onset in the first year of life: A multicenter cohort study. Epilepsia 2013; 54 Suppl 7:66-9. [DOI: 10.1111/epi.12311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lucio Giordano
- Child Neuropsychiatry; Regional Epilepsy Center; Brescia Italy
| | - Aglaia Vignoli
- Epilepsy Center; San Paolo Hospital; University of Milan; Milan Italy
| | | | - Pasquale Parisi
- Child Neurology; NESMOS Department; Faculty of Medicine and Psychology; Sapienza University; Rome Italy
| | | | - Giangennaro Coppola
- Child and Adolescent Neuropsychiatry; Medical School; University of Salerno; Salerno Italy
| | - Duccio Maria Cordelli
- Child Neurology and Psychiatry Unit; University of Bologna; S. Orsola-Malpighi Hospital; Bologna Italy
| | | | - Giuseppe Milito
- Child Neuropsychiatry; Regional Epilepsy Center; Brescia Italy
| | | | - Dario Pruna
- Child and Adolescent Neuropsychiatry; University Hospital; Cagliari Italy
| | | | | | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health; University of Genoa and “G. Gaslini” Institute; Genoa Italy
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Agostinelli S, Accorsi P, Beccaria F, Belcastro V, Canevini MP, Capovilla G, Cappanera S, Bernardina BD, Darra F, Gaudio LD, Elia M, Falsaperla R, Giordano L, Gobbi G, Minetti C, Nicita F, Parisi P, Pavone P, Pezzella M, Sesta M, Spalice A, Striano S, Tozzi E, Traverso M, Vari S, Vignoli A, Zamponi N, Zara F, Striano P, Verrotti A. Clinical dissection of early onset absence epilepsy in children and prognostic implications. Epilepsia 2013; 54:1761-70. [PMID: 24032425 DOI: 10.1111/epi.12341] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Sergio Agostinelli
- Child Epilepsy Center; Department of Pediatrics; University of Chieti; Chieti; Italy
| | | | | | | | | | | | - Silvia Cappanera
- Department of Pediatric Neurology; Hospital “Ospedali Riuniti”; Ancona; Italy
| | | | - Francesca Darra
- Unit of Child Neuropsychiatry; University of Verona; Verona; Italy
| | - Luigi Del Gaudio
- Department of Neurological Sciences; Federico II University; Naples; Italy
| | - Maurizio Elia
- Department of Neurology; Institute “Oasi”; Troina; Italy
| | | | - Lucio Giordano
- Child Neuropsychiatry Unit; Hospital “Civile”; Brescia; Italy
| | - Giuseppe Gobbi
- Department of Child Neuropsychiatry; Hospital “Maggiore”; Bologna; Italy
| | - Carlo Minetti
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | - Francesco Nicita
- Child Neurology Unit; Department of Pediatrics; La Sapienza University; Rome; Italy
| | - Pasquale Parisi
- Child Neurology; II Faculty of Medicine; La Sapienza University; Rome; Italy
| | - Piero Pavone
- Department of Pediatrics; Hospital “V. Emanuele”; Catania; Italy
| | - Marianna Pezzella
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | - Michela Sesta
- Child Neurology; Children's Hospital “Giovanni XIII”; Bari; Italy
| | - Alberto Spalice
- Child Neurology Unit; Department of Pediatrics; La Sapienza University; Rome; Italy
| | - Salvatore Striano
- Department of Neurological Sciences; Federico II University; Naples; Italy
| | - Elisabetta Tozzi
- Department of Child Neuropsychiatry; University of L'Aquila; L'Aquila; Italy
| | - Monica Traverso
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | - Stella Vari
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | | | - Nelia Zamponi
- Department of Pediatric Neurology; Hospital “Ospedali Riuniti”; Ancona; Italy
| | - Federico Zara
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | - Pasquale Striano
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
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Tsuda Y, Oguni H, Sakauchi M, Osawa M. An electroclinical study of absence seizures in Dravet syndrome. Epilepsy Res 2013; 103:88-96. [DOI: 10.1016/j.eplepsyres.2012.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 06/19/2012] [Accepted: 07/03/2012] [Indexed: 10/28/2022]
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Lenkov DN, Volnova AB, Pope ARD, Tsytsarev V. Advantages and limitations of brain imaging methods in the research of absence epilepsy in humans and animal models. J Neurosci Methods 2012; 212:195-202. [PMID: 23137652 DOI: 10.1016/j.jneumeth.2012.10.018] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 10/24/2012] [Accepted: 10/25/2012] [Indexed: 12/18/2022]
Abstract
The purpose of this review is to analyze research possibilities and limitations of several methods, technical tools and their combinations for elucidation of absence epilepsy mechanisms, particularly the childhood absences. Despite the notable collection of simultaneous recording of clinical electroencephalography (EEG) and behavioral changes in relation to absence seizures, shortcomings of scalp EEG in both spatial resolution and precise detection of subcortical centers have limited the understanding of the fundamental mechanisms of altered brain function during and after recurrent epileptic paroxysms. Therefore, in the past decade, EEG recordings have often been combined with simultaneous imaging methods in epilepsy studies. Among imaging methods, the following ones are used regularly: functional magnetic resonance imaging (fMRI), positron-emission tomography (PET), low-resolution electromagnetic tomography (LORETA), single photon emission spectroscopy (SPECT), near-infrared spectroscopy (NIRS), and optical imaging of intrinsic signals (IOS). In addition, voltage-sensitive dye optical imaging method and even photoacoustic microscopy can be applied to animal models of epilepsy. Samplings of some of the most relevant data obtained by the above methods are presented. It appears that the elaboration of more adequate animal models of the patterns of absence seizures during the early postnatal period is necessary for better correspondence of human and animal absence phenomena.
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Affiliation(s)
- Dmitry N Lenkov
- Nevsky Center of Scientific Collaboration-Saint Petersburg, Razjezshaya 43/1 Liter A, Suite 8N, Saint Petersburg 192119, Russia
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Agostinelli S, Traverso M, Accorsi P, Beccaria F, Belcastro V, Capovilla G, Cappanera S, Coppola A, Dalla Bernardina B, Darra F, Ferretti M, Elia M, Galeone D, Giordano L, Gobbi G, Nicita F, Parisi P, Pezzella M, Spalice A, Striano S, Tozzi E, Vignoli A, Minetti C, Zara F, Striano P, Verrotti A. Early-onset absence epilepsy:SLC2A1gene analysis and treatment evolution. Eur J Neurol 2012; 20:856-9. [DOI: 10.1111/j.1468-1331.2012.03871.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 08/16/2012] [Indexed: 11/30/2022]
Affiliation(s)
- S. Agostinelli
- Department of Pediatrics; University of Chieti; Chieti; Italy
| | - M. Traverso
- Pediatric Neurology and Muscular Diseases Unit; ‘G. Gaslini’ Institute; Genoa; Italy
| | - P. Accorsi
- Child Neuropsychiatry; Spedali Civili; Brescia; Italy
| | - F. Beccaria
- Department of Child Neuropsychiatry; C. Poma Hospital; Mantova; Italy
| | - V. Belcastro
- Department of Neuroscience; Sant'Anna Hospital; Como; Italy
| | - G. Capovilla
- Department of Child Neuropsychiatry; C. Poma Hospital; Mantova; Italy
| | - S. Cappanera
- Department of Pediatric Neurology; Ospedali Riuniti; Ancona; Italy
| | - A. Coppola
- Department of Neurological Sciences; Federico II University; Naples; Italy
| | | | - F. Darra
- Unit of Child Neuropsychiatry; University of Verona; Verona; Italy
| | - M. Ferretti
- Pediatric Neurology and Muscular Diseases Unit; ‘G. Gaslini’ Institute; Genoa; Italy
| | - M. Elia
- Department of Neurology; Oasi Institute for Research on Mental Retardation and Brain Aging; Troina; Italy
| | - D. Galeone
- Child Neurology; Children's Hospital Giovanni XXIII; Bari; Italy
| | - L. Giordano
- Child Neuropsychiatry; Spedali Civili; Brescia; Italy
| | - G. Gobbi
- Department of Child Neuropsychiatry; Maggiore Hospital; Bologna; Italy
| | - F. Nicita
- Department of Pediatrics; University of Rome ‘La Sapienza’; Rome; Italy
| | - P. Parisi
- Child Neurology; II Faculty of Medicine; ‘La Sapienza’ University; Rome; Italy
| | - M. Pezzella
- Pediatric Neurology and Muscular Diseases Unit; ‘G. Gaslini’ Institute; Genoa; Italy
| | - A. Spalice
- Child Neurology Unit; Department of Pediatrics; ‘La Sapienza’ University; Rome; Italy
| | - S. Striano
- Department of Neurological Sciences; Federico II University; Naples; Italy
| | - E. Tozzi
- Department of Child Neuropsychiatry; University of L'Aquila; L'Aquila; Italy
| | - A. Vignoli
- Epilepsy Center; University of Milan; Milan; Italy
| | - C. Minetti
- Pediatric Neurology and Muscular Diseases Unit; ‘G. Gaslini’ Institute; Genoa; Italy
| | - F. Zara
- Pediatric Neurology and Muscular Diseases Unit; ‘G. Gaslini’ Institute; Genoa; Italy
| | - P. Striano
- Pediatric Neurology and Muscular Diseases Unit; ‘G. Gaslini’ Institute; Genoa; Italy
| | - A. Verrotti
- Department of Pediatrics; University of Chieti; Chieti; Italy
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A clinical and genetic study of 33 new cases with early-onset absence epilepsy. Epilepsy Res 2011; 95:221-6. [DOI: 10.1016/j.eplepsyres.2011.03.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 03/15/2011] [Accepted: 03/25/2011] [Indexed: 11/23/2022]
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Verrotti A, Agostinelli S, Olivieri C, Chiarelli F, Curatolo P. Early-onset pure absence epilepsy: a distinct epileptic syndrome. Acta Paediatr 2011; 100:647-50. [PMID: 21352361 DOI: 10.1111/j.1651-2227.2011.02213.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED Early-onset pure absence epilepsy has not yet considered in the International League Against Epilepsy classification, but several reports have supported its existence as a distinct epileptic syndrome primarily manifesting with typical absences in early childhood. This review summarizes the current understanding on this epilepsy. CONCLUSIONS Early-onset pure absence epilepsy is a distinct epilepsy characterized by absences starting from a few months to 4 years of age, normal early psychomotor development, good antiepileptic drug seizure control and normal intellectual outcome.
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Verrotti A, Olivieri C, Agostinelli S, Coppola G, Parisi P, Grosso S, Spalice A, Zamponi N, Franzoni E, Iannetti P, Chiarelli F, Curatolo P. Long term outcome in children affected by absence epilepsy with onset before the age of three years. Epilepsy Behav 2011; 20:366-9. [PMID: 21227756 DOI: 10.1016/j.yebeh.2010.12.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 12/01/2010] [Accepted: 12/08/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The goal of this study was to define the long-term outcome of absence epilepsy presenting before the age of 3 years. METHODS We retrospectively studied the medical records of 40 children from eight neuropediatric centers in Italy with respect to the personal and family histories of epilepsy or febrile seizures, time of follow-up, cognitive functions, treatment, and outcome. RESULTS Forty patients were enrolled in this study. They all fulfilled the criteria for absence epilepsy with 3-Hz spike-wave complexes on the EEG, normal neurological examination, and no other seizures types. Seizure onset occurred between 24.1 and 36.0 months. There was a family history of epilepsy in 28%, and of febrile seizures in 13%. Thirty-three patients were treated with valproic acid (VPA), mostly used in monotherapy (26 patients) or in association with ethosuximide. At final follow-up, 33 patients were seizure free and 29 had normal EEGs. Thirty-four patients had a normal intelligence quotient (IQ), whereas 6 had a decreased IQ, mainly associated with poor control of seizures. CONCLUSION In our series, absence seizures presenting before the age of 3 appeared to have quite a good long-term clinical prognosis; the neuropsychological outcome was comparable to that of childhood epilepsy presenting after 3 years of age.
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Ma X, Zhang Y, Yang Z, Liu X, Sun H, Qin J, Wu X, Liang J. Childhood absence epilepsy: Elctroclinical features and diagnostic criteria. Brain Dev 2011; 33:114-9. [PMID: 20378290 DOI: 10.1016/j.braindev.2010.02.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 12/29/2009] [Accepted: 02/16/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To analyze the electroclinical features of children with childhood absence epilepsy (CAE) and discuss the diagnostic criteria for CAE. METHODS The video-electroencephalogram (VEEG) database in our hospital was searched using "absence seizures" and "3-Hz generalized spike and waves (GSW)" as key-words. Other epileptic syndromes with typical absence seizures were carefully excluded. Children meeting the CAE diagnostic criteria of the International League Against Epilepsy (ILAE) in 1989 were further evaluated with the diagnostic criteria proposed by Panayiotopoulos in 2005. RESULTS Totally 37 children met the 1989 ILAE criteria of CAE. The onset age of absence seizures ranged from 3 to 11 years. All patients had frequent absence seizures (5-60 times per day). Two patients (5.4%) had generalized tonic-clonic seizures. Hyperventilation induced absences in all patients. VEEG confirmed that 7 patients (18.9%) had only simple absences, 25 patients (67.6%) had only complex absences, and 5 patients (13.5%) had both simple and complex absences. Ictal EEG showed 3Hz GSW discharges in all patients. The seizure duration ranged from 3 to 40s. Four patients (10.8%) had two spikes per wave in ictal EEG. GSW fragments were found in 29 patients (78.4%) during sleep. Interictal polyspikes and waves were present in 17 patients (45.9%). Focal discharges predominantly in the anterior regions, were found in 22 patients (56.8%). Only 7 patients (18.9%) met the diagnostic criteria proposed by Panayiotopoulos in 2005. CONCLUSIONS Few patients meeting the 1989 ILAE diagnostic criteria for CAE meet the new diagnostic criteria proposed by Panayiotopoulos in 2005. The new criteria for CAE are too strict to appropriately classify some patients.
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Affiliation(s)
- Xiuwei Ma
- Department of Pediatrics, Peking University First Hospital, Xicheng District, Beijing, PR China
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13
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Caraballo RH, Darra F, Fontana E, Garcia R, Monese E, Dalla Bernardina B. Absence seizures in the first 3 years of life: an electroclinical study of 46 cases. Epilepsia 2011; 52:393-400. [PMID: 21269284 DOI: 10.1111/j.1528-1167.2010.02926.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE Early onset absence seizures have been considered a rare heterogeneous group with a poor prognosis. Only few patients may be categorized into well-known syndromes. We have evaluated electroclinical features, evolution, and the nosologic boundaries of early onset absence seizures. METHODS Forty-six neurologically normal patients with absence seizures associated with bilateral, synchronic, or asynchronic, and symmetric or asymmetric spike-and-wave paroxysms with onset in the first 3 years of life were included. Patients with abnormal neurologic examination and brain imaging were excluded from the study. KEY FINDINGS In our study, 39 patients met the clinical and electroencephalography (EEG) criteria of well-defined epileptic syndromes. Childhood absence epilepsy was found in 11 patients, benign myoclonic epilepsy in infancy in 18 patients, eyelid myoclonic epilepsy in 4, and epilepsy with myoclonic absences in 6. We did not find clinical and EEG criteria of well-recognized epileptic syndromes in seven children. Nine of 11 patients with simple absence seizures became seizure free. All these patients had normal neurologic and neuropsychological evaluations. Of the 35 patients who had absence seizures associated with myoclonic seizures, 20 became seizure free. Fifteen of 35 children continue having seizures. At the last visit, 20 of these 35 patients had normal neurologic and neuropsychological evaluations, 11 presented with mild mental retardation, and 4 with severe mental retardation. SIGNIFICANCE Epilepsies with absence seizures of early onset are relatively uncommon. Most of the patients had well-defined epileptic syndromes with a variable evolution. The evolution depended on the epileptic syndromes.
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Affiliation(s)
- Roberto Horacio Caraballo
- Department of Neurology, Hospital Nacional de Pediatría Prof Dr Juan P Garrahan, Buenos Aires, Argentina.
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Hughes JR. Absence seizures: a review of recent reports with new concepts. Epilepsy Behav 2009; 15:404-12. [PMID: 19632158 DOI: 10.1016/j.yebeh.2009.06.007] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Revised: 06/02/2009] [Accepted: 06/07/2009] [Indexed: 02/01/2023]
Abstract
Absence seizures with bilateral spike-wave (SW) complexes at 3Hz are divided into the childhood form, with onset at around 6 years of age, and the juvenile form, with onset usually at 12 years of age. These seizures typically last 9-12s and, at times, are activated by hyperventilation and occasionally by photic stimulation. Generalized tonic-clonic (GTC) seizures may also occur, especially in the juvenile form. There may be cognitive changes, in addition to linguistic and behavioral problems. Possible mechanisms for epileptogenesis may involve GABAergic systems, but especially T-calcium channels. The thalamus, especially the reticular nucleus, plays a major role, as does the frontal cortex, mainly the dorsolateral and orbital frontal areas, to the extent that some investigators have concluded that absence seizures are not truly generalized, but rather have selective cortical networks, mainly ventromesial frontal areas and the somatosensory cortex. The latter network is a departure from the more popular concept of a generalized epilepsy. Between the "centrencephalic" and "corticoreticular" theories, a "unified" theory is presented. Proposed genes include T-calcium channel gene CACNA1H, likely a susceptible gene in the Chinese Han population and a contributory gene in Caucasians. Electroencephalography has revealed an interictal increase in prefrontal activity, essential for the buildup of the ictal SW complexes maximal in that region. Infraslow activity can also be seen during ictal SW complexes. For treatment, counter to common belief, ethosuximide may not increase GTC seizures, as it reduces low-threshold T-calcium currents in thalamic neurons. Valproic acid and lamotrigine are also first-line medications. In addition, zonisamide and levetiracetam can be very helpful in absence epilepsy.
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Affiliation(s)
- John R Hughes
- Department of Neurology, University of Illinois Medical Center (M/C 796), 912 South Wood Street, Chicago, IL 60612, USA.
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15
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Current world literature. Curr Opin Obstet Gynecol 2008; 20:602-7. [PMID: 18989138 DOI: 10.1097/gco.0b013e32831ceeb3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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