Clinical and Electrophysiological Features Predicting Response to Antiseizure Medications in Juvenile Absence Epilepsy

Abstract

Background We aimed to evaluate the clinical findings and electroencephalographic (EEG) characteristics of patients with juvenile absence epilepsy (JAE) and to determine the factors that predict response to antiseizure medications (ASMs) in JAE.

Methods We reviewed the medical records of 29 patients with JAE. The patients who were seizure-free during the last 12 months of their follow-up and who did not have generalized spike waves on their last EEG were considered as the treatment-responsive group, and the patients whose clinical seizures persisted during the last 12 months of their follow-up or who had generalized spike waves on their follow-up EEGs were considered as patients who did not respond to ASMs.

Results There were 29 patients, 20 girls and nine boys, with a mean age of 13.34 ± 2.17 years and a follow-up time of 32.1 ± 11.9 months. Twenty-two cases (75.8%) were evaluated as responsive to treatment. Generalized tonic–clonic seizures (GTCS) were statistically more common in patients who did not respond to ASM. Epileptic seizures began at a younger age in the group that responded to medication. Occipital intermittent rhythmic delta activity (OIRDA) in EEG was significantly higher in the group that responded to the medication.

Conclusion Our study shows that concomitant GTCS may predict poorer response to ASMs in JAE. Younger age at diagnosis and OIRDA on EEG may be associated with better response to treatment. Our findings need to be confirmed by further prospective and long-term studies.

Keywords

antiseizure medication - juvenile absence epilepsy - treatment - prognosis

Publication History

Received: 15 July 2021

Accepted: 08 April 2022

Article published online:
23 December 2022

• References

• 1 Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia 1989; 30 (04) 389-399
• 2 Gelisse P, Wolf P, Inoue Y. Juvenile absence epilepsy. In: Bureau M, Genton P, Dravet C, Delgado-Escueta A, Tassinari P, Thomas P, Wolf P. eds. Epileptic Syndromes in Infancy, Childhood and Adolescence. 5th edition. Montrouge: John Libbey Eurotext Ltd; 2012: 329-339
• 3 Healy L, Moran M, Singhal S, O'Donoghue MF, Alzoubidi R, Whitehouse WP. Relapse after treatment withdrawal of antiepileptic drugs for juvenile absence epilepsy and juvenile myoclonic epilepsy. Seizure 2018; 59: 116-122
• 4 Asadi-Pooya AA, Farazdaghi M. Seizure outcome in patients with juvenile absence epilepsy. Neurol Sci 2016; 37 (02) 289-292
• 5 Danhofer P, Brázdil M, Ošlejšková H, Kuba R. Long-term seizure outcome in patients with juvenile absence epilepsy; a retrospective study in a tertiary referral center. Seizure 2014; 23 (06) 443-447
• 6 Trinka E, Baumgartner S, Unterberger I. et al. Long-term prognosis for childhood and juvenile absence epilepsy. J Neurol 2004; 251 (10) 1235-1241
• 7 Wirrell E, Camfield C, Camfield P, Dooley J. Prognostic significance of failure of the initial antiepileptic drug in children with absence epilepsy. Epilepsia 2001; 42 (06) 760-763
• 8 Tovia E, Goldberg-Stern H, Shahar E, Kramer U. Outcome of children with juvenile absence epilepsy. J Child Neurol 2006; 21 (09) 766-768
• 9 Aiguabella Macau M, Falip Centellas M, Veciana de Las Heras M. et al. Long term prognosis of juvenile absence epilepsy. Neurologia 2011; 26 (04) 193-199
• 10 Yoshinaga H, Ohtsuka Y, Tamai K. et al. EEG in childhood absence epilepsy. Seizure 2004; 13 (05) 296-302
• 11 Guilhoto LM, Manreza ML, Yacubian EM. Occipital intermittent rhythmic delta activity in absence epilepsy. Arq Neuropsiquiatr 2006; 64 (2A): 193-197