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Smith KM, Wirrell EC, Andrade DM, Choi H, Trenité DKN, Knupp KG, Nordli DR, Riva A, Stern JM, Striano P, Thiele EA, Zawar I. A comprehensive narrative review of epilepsy with eyelid myoclonia. Epilepsy Res 2023; 193:107147. [PMID: 37121024 DOI: 10.1016/j.eplepsyres.2023.107147] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/02/2023]
Abstract
Epilepsy with eyelid myoclonia (EEM) is a generalized epilepsy syndrome with childhood-onset and 2:1 female predominance that consists of: 1. eyelid myoclonia with or without absence seizures, 2. eye closure induced seizures or EEG paroxysms, 3. clinical or EEG photosensitivity. While eyelid myoclonia is the disease hallmark, other seizure types, including absence seizures and generalized tonic-clonic seizures, may be present. It is thought to have a genetic etiology, and around one-third of patients may have a positive family history of epilepsy. Recently, specific genetic mutations have been recognized in a minority patients, including in SYNGAP1, NEXMIF, RORB, and CHD2 genes. There are no randomized controlled trials in EEM, and the management literature is largely restricted to small retrospective studies. Broad-spectrum antiseizure medications such as valproate, levetiracetam, lamotrigine, and benzodiazepines are typically used. Seizures typically persist into adulthood, and drug-resistant epilepsy is reported in over 50%.
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Affiliation(s)
- Kelsey M Smith
- Department of Neurology, Mayo Clinic, Rochester, MN, United States.
| | - Elaine C Wirrell
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | | | - Hyunmi Choi
- Department of Neurology, Columbia University, New York, NY, United States
| | | | - Kelly G Knupp
- Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Douglas R Nordli
- Department of Neurology, University of Chicago, Chicago, IL, United States
| | - Antonella Riva
- IRCCS Istituto Giannina Gaslini", Genova, Italy and Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - John M Stern
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States
| | - Pasquale Striano
- IRCCS Istituto Giannina Gaslini", Genova, Italy and Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Elizabeth A Thiele
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
| | - Ifrah Zawar
- Department of Neurology, University of Virginia, Charlottesville, VA, United States
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Hanaoka Y, Yoshinaga H, Kobayashi K. A ten-year follow-up cohort study of childhood epilepsy: Changes in epilepsy diagnosis with age. Brain Dev 2017; 39:312-320. [PMID: 27847129 DOI: 10.1016/j.braindev.2016.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/21/2016] [Accepted: 10/24/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To elucidate all of the characteristics of childhood epilepsy, we performed a long-term follow-up study on the patients who visited Okayama University Hospital. SUBJECTS AND METHODS We retrospectively investigated the patients who were involved in the previous epidemiological study and visited Okayama University Hospital for a period of 10years after December 31, 1999. RESULTS Overall, there were 350 patients' medical records that were evaluated, and 258 patients with complete clinical information available for a 10-year period were enrolled. Ten patients died and the remaining 82 were lost to follow-up. Of 258 patients with complete information, 153 (59.3%) were seizure-free for at least 5years. One hundred thirty (50.4%) had intellectual disabilities and 77 (29.8%) had motor disabilities, including 75 (29.1%) with both disabilities on December 31, 2009. Thirty-four patients of 350 (9.7%) changed the epilepsy classification during follow-up. With regard to ten patients who died, nine of them had symptomatic epilepsy, particularly those with severe underlying disorders with an onset during the first year of life. CONCLUSION Clinical status considerably changed during the decade-long follow-up period in childhood epilepsy. Changes in the epilepsy diagnosis are especially important and should be taken into account in the long-term care of children with epilepsy.
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Affiliation(s)
- Yoshiyuki Hanaoka
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital, Okayama, Japan.
| | - Harumi Yoshinaga
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital, Okayama, Japan
| | - Katsuhiro Kobayashi
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama University Hospital, Okayama, Japan
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Jonsson P, Jonsson B, Eeg-Olofsson O. Psychological and social outcome of epilepsy in well-functioning children and adolescents. A 10-year follow-up study. Eur J Paediatr Neurol 2014; 18:381-90. [PMID: 24565749 DOI: 10.1016/j.ejpn.2014.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 12/17/2013] [Accepted: 01/26/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND From a population based study of epilepsy in Swedish children a subgroup designated well-functioning with an epilepsy diagnosis in 1997 was worked up from a medical point of view 10 years later. AIM To describe the psychological and social outcome in this subgroup. METHODS Thirty-one patients aged 11-22 years and their parents/partners responded to a questionnaire according to Achenbach System of Empirically Based Assessment (ASEBA) to evaluate behavioural and emotional problems, and social competence. RESULTS Active epilepsy, diagnosed in 32%, was related to attention problems, somatic complaints, and school problems. Polytherapy, used in 16%, was related to attention problems and aggressive behaviour. School problems were found in six of seven children younger than 18 years. Internalizing, externalizing, and 'other' syndromes were found in 29% of the individuals, but a grouping of these syndromes in the clinical range only in two (6.5%), a girl with generalized tonic-clonic seizures alone, and a boy with structural focal epilepsy. Both had active epilepsy and were treated with polytherapy. All ten individuals with Rolandic epilepsy were classified as normal. The answers to the ASEBA questionnaire of individuals and parents/partners were inconsistent, and parents generally stated more problems than the individuals. SUMMARY This 10-year follow-up study of psychological and social outcome in well-functioning children and adolescents with childhood onset epilepsy shows some emotional, behavioural, and social problems. Thus, early information to increase knowledge about epilepsy and associated psychological co-morbidities in order to decrease risk of low self-esteem, social anxiety, and depression later in life is of importance.
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Affiliation(s)
- Pysse Jonsson
- Department of Women's and Children's Health, Neuropaediatrics, Uppsala University, Uppsala, Sweden.
| | - Björn Jonsson
- Department of Women's and Children's Health, Neuropaediatrics, Uppsala University, Uppsala, Sweden
| | - Orvar Eeg-Olofsson
- Department of Women's and Children's Health, Neuropaediatrics, Uppsala University, Uppsala, Sweden
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Melbourne Chambers R, Morrison-Levy N, Chang S, Tapper J, Walker S, Tulloch-Reid M. Cognition, academic achievement, and epilepsy in school-age children: a case-control study in a developing country. Epilepsy Behav 2014; 33:39-44. [PMID: 24632351 DOI: 10.1016/j.yebeh.2014.02.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 02/02/2014] [Accepted: 02/04/2014] [Indexed: 10/25/2022]
Abstract
We conducted a case-control study of 33 Jamaican children 7 to 12years old with uncomplicated epilepsy and 33 of their classroom peers matched for age and gender to determine whether epilepsy resulted in differences in cognitive ability and school achievement and if socioeconomic status or the environment had a moderating effect on any differences. Intelligence, language, memory, attention, executive function, and mathematics ability were assessed using selected tests from NEPSY, WISCR, TeaCh, WRAT3 - expanded, and Raven's Coloured Progressive Matrices. The child's environment at home was measured using the Middle Childhood HOME inventory. Socioeconomic status was determined from a combination of household, crowding, possessions, and sanitation. We compared the characteristics of the cases and controls and used random effects regression models (using the matched pair as the cluster) to examine the relationship between cognition and epilepsy. We found that there was no significant difference in IQ, but children with epilepsy had lower scores on tests of memory (p<0.05), language (p<0.05), and attention (p<0.01) compared with their controls. In random effects models, epilepsy status had a significant effect on memory (coefficient=-0.14, CI: -0.23, -0.05), language (coefficient=-0.13, CI: -0.23, -0.04), and mathematics ability (coefficient=-0.01, CI: -0.02, -0.00). Adjustment for the home environment and socioeconomic status and inclusion of interaction terms for these variables did not alter these effects. In conclusion, we found that epilepsy status in Jamaican children has a significant effect on performance on tests of memory, language, and mathematics and that this effect is not modified or explained by socioeconomic status or the child's home environment.
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Affiliation(s)
- R Melbourne Chambers
- Department of Child and Adolescent Health, University of the West Indies (UWI), Mona, Jamaica.
| | - N Morrison-Levy
- Bustamante Hospital for Children, Arthur Wint Drive, Kingston, Jamaica.
| | - S Chang
- Epidemiology Research Unit, Tropical Medicine Research Institute, UWI, Mona, Jamaica.
| | - J Tapper
- Bustamante Hospital for Children, Arthur Wint Drive, Kingston, Jamaica.
| | - S Walker
- Epidemiology Research Unit, Tropical Medicine Research Institute, UWI, Mona, Jamaica.
| | - M Tulloch-Reid
- Epidemiology Research Unit, Tropical Medicine Research Institute, UWI, Mona, Jamaica.
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