Clinical dissection of early onset absence epilepsy in children and prognostic implications

Sergio Agostinelli, Patrizia Accorsi, Francesca Beccaria, Vincenzo Belcastro, Maria Paola Canevini, Giuseppe Capovilla, Silvia Cappanera, Bernardo Dalla Bernardina, Francesca Darra, Luigi Del Gaudio, Maurizio Elia, Raffaele Falsaperla, Lucio Giordano, Giuseppe Gobbi, Carlo Minetti, Francesco Nicita, Pasquale Parisi, Piero Pavone, Marianna Pezzella, Michela Sesta & 10 others Alberto Spalice, Salvatore Striano, Elisabetta Tozzi, Monica Traverso, Stella Vari, Aglaia Vignoli, Nelia Zamponi, Federico Zara, Pasquale Striano, Alberto Verrotti

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Summary Purpose To investigate whether patients with typical absence seizures (TAS) starting in the first 3 years of life, conformed to Panayiotopoulos's definition of childhood absence epilepsy (CAE), show different electroclinical course than those not fulfilling CAE criteria. Methods In this multicenter retrospective study, we choose a fixed duration follow-up of 36 months to examine the electroclinical course of epilepsy in all children with TAS starting before 3 years of age. The probands who fulfilled Panayiotopoulos's criteria for CAE were classified as having pure early onset absence epilepsy (P-EOAE), whereas those who did not as nonpure EOAE (NP-EOAE). In addition, these two groups of patients were further stratified according to the number of antiepileptic drugs taken to obtain initial seizure control (mono-, bi-, and tritherapy). Key Findings Patients with P-EOAE (n = 111) showed earlier initial seizure control (p = 0.030) and better seizure-free survival curve (p = 0.004) than those with NP-EOAE (n = 77). No mutation in SLC2A1 gene or abnormal neuroimaging was observed in P-EOAE. Among patients with NP-EOAE, those receiving tritherapy showed increased risk of structural brain abnormalities (p = 0.001) or SLC2A1 mutations (p = 0.001) but fewer myoclonic features (p = 0.031) and worse seizure-free survival curve (p = 0.047) than those treated with mono- and bitherapy. Children with NP-EOAE had 2.134 the odds of having relapse during the follow-up compare to those with P-EOAE. Significance Children with early onset TAS who did meet Panayiotopoulos's criteria showed a favorable course of epilepsy, whereas patients not fulfilling Panayiotopoulos's criteria showed increased risk of relapse at long-term follow-up.

Original languageEnglish
Pages (from-to)1761-1770
Number of pages10
JournalEpilepsia
Volume54
Issue number10
DOIs
Publication statusPublished - Oct 2013

Fingerprint

Absence Epilepsy
Dissection
Seizures
Epilepsy
Recurrence
Mutation
Survival
Neuroimaging
Anticonvulsants
Multicenter Studies
Retrospective Studies

Keywords

  • Antiepileptic drugs
  • Childhood absence epilepsy
  • Early onset absence epilepsy
  • GLUT1 deficiency
  • Typical absence seizures

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Agostinelli, S., Accorsi, P., Beccaria, F., Belcastro, V., Canevini, M. P., Capovilla, G., ... Verrotti, A. (2013). Clinical dissection of early onset absence epilepsy in children and prognostic implications. Epilepsia, 54(10), 1761-1770. https://doi.org/10.1111/epi.12341

Clinical dissection of early onset absence epilepsy in children and prognostic implications. / Agostinelli, Sergio; Accorsi, Patrizia; Beccaria, Francesca; Belcastro, Vincenzo; Canevini, Maria Paola; Capovilla, Giuseppe; Cappanera, Silvia; Bernardina, Bernardo Dalla; Darra, Francesca; Gaudio, Luigi Del; Elia, Maurizio; Falsaperla, Raffaele; Giordano, Lucio; Gobbi, Giuseppe; Minetti, Carlo; Nicita, Francesco; Parisi, Pasquale; Pavone, Piero; Pezzella, Marianna; Sesta, Michela; Spalice, Alberto; Striano, Salvatore; Tozzi, Elisabetta; Traverso, Monica; Vari, Stella; Vignoli, Aglaia; Zamponi, Nelia; Zara, Federico; Striano, Pasquale; Verrotti, Alberto.

In: Epilepsia, Vol. 54, No. 10, 10.2013, p. 1761-1770.

Research output: Contribution to journalArticle

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 2013, 'Clinical dissection of early onset absence epilepsy in children and prognostic implications', Epilepsia, vol. 54, no. 10, pp. 1761-1770. https://doi.org/10.1111/epi.12341
Agostinelli S, Accorsi P, Beccaria F, Belcastro V, Canevini MP, Capovilla G et al. Clinical dissection of early onset absence epilepsy in children and prognostic implications. Epilepsia. 2013 Oct;54(10):1761-1770. https://doi.org/10.1111/epi.12341
Agostinelli, Sergio ; Accorsi, Patrizia ; Beccaria, Francesca ; Belcastro, Vincenzo ; Canevini, Maria Paola ; Capovilla, Giuseppe ; Cappanera, Silvia ; Bernardina, Bernardo Dalla ; Darra, Francesca ; Gaudio, Luigi Del ; Elia, Maurizio ; Falsaperla, Raffaele ; Giordano, Lucio ; Gobbi, Giuseppe ; Minetti, Carlo ; Nicita, Francesco ; Parisi, Pasquale ; Pavone, Piero ; Pezzella, Marianna ; Sesta, Michela ; Spalice, Alberto ; Striano, Salvatore ; Tozzi, Elisabetta ; Traverso, Monica ; Vari, Stella ; Vignoli, Aglaia ; Zamponi, Nelia ; Zara, Federico ; Striano, Pasquale ; Verrotti, Alberto. / Clinical dissection of early onset absence epilepsy in children and prognostic implications. In: Epilepsia. 2013 ; Vol. 54, No. 10. pp. 1761-1770.
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author = "Sergio Agostinelli and Patrizia Accorsi and Francesca Beccaria and Vincenzo Belcastro and Canevini, {Maria Paola} and Giuseppe Capovilla and Silvia Cappanera and Bernardina, {Bernardo Dalla} and Francesca Darra and Gaudio, {Luigi Del} and Maurizio Elia and Raffaele Falsaperla and Lucio Giordano and Giuseppe Gobbi and Carlo Minetti and Francesco Nicita and Pasquale Parisi and Piero Pavone and Marianna Pezzella and Michela Sesta and Alberto Spalice and Salvatore Striano and Elisabetta Tozzi and Monica Traverso and Stella Vari and Aglaia Vignoli and Nelia Zamponi and Federico Zara and Pasquale Striano and Alberto Verrotti",
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T1 - Clinical dissection of early onset absence epilepsy in children and prognostic implications

AU - Agostinelli, Sergio

AU - Accorsi, Patrizia

AU - Beccaria, Francesca

AU - Belcastro, Vincenzo

AU - Canevini, Maria Paola

AU - Capovilla, Giuseppe

AU - Cappanera, Silvia

AU - Bernardina, Bernardo Dalla

AU - Darra, Francesca

AU - Gaudio, Luigi Del

AU - Elia, Maurizio

AU - Falsaperla, Raffaele

AU - Giordano, Lucio

AU - Gobbi, Giuseppe

AU - Minetti, Carlo

AU - Nicita, Francesco

AU - Parisi, Pasquale

AU - Pavone, Piero

AU - Pezzella, Marianna

AU - Sesta, Michela

AU - Spalice, Alberto

AU - Striano, Salvatore

AU - Tozzi, Elisabetta

AU - Traverso, Monica

AU - Vari, Stella

AU - Vignoli, Aglaia

AU - Zamponi, Nelia

AU - Zara, Federico

AU - Striano, Pasquale

AU - Verrotti, Alberto

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N2 - Summary Purpose To investigate whether patients with typical absence seizures (TAS) starting in the first 3 years of life, conformed to Panayiotopoulos's definition of childhood absence epilepsy (CAE), show different electroclinical course than those not fulfilling CAE criteria. Methods In this multicenter retrospective study, we choose a fixed duration follow-up of 36 months to examine the electroclinical course of epilepsy in all children with TAS starting before 3 years of age. The probands who fulfilled Panayiotopoulos's criteria for CAE were classified as having pure early onset absence epilepsy (P-EOAE), whereas those who did not as nonpure EOAE (NP-EOAE). In addition, these two groups of patients were further stratified according to the number of antiepileptic drugs taken to obtain initial seizure control (mono-, bi-, and tritherapy). Key Findings Patients with P-EOAE (n = 111) showed earlier initial seizure control (p = 0.030) and better seizure-free survival curve (p = 0.004) than those with NP-EOAE (n = 77). No mutation in SLC2A1 gene or abnormal neuroimaging was observed in P-EOAE. Among patients with NP-EOAE, those receiving tritherapy showed increased risk of structural brain abnormalities (p = 0.001) or SLC2A1 mutations (p = 0.001) but fewer myoclonic features (p = 0.031) and worse seizure-free survival curve (p = 0.047) than those treated with mono- and bitherapy. Children with NP-EOAE had 2.134 the odds of having relapse during the follow-up compare to those with P-EOAE. Significance Children with early onset TAS who did meet Panayiotopoulos's criteria showed a favorable course of epilepsy, whereas patients not fulfilling Panayiotopoulos's criteria showed increased risk of relapse at long-term follow-up.

AB - Summary Purpose To investigate whether patients with typical absence seizures (TAS) starting in the first 3 years of life, conformed to Panayiotopoulos's definition of childhood absence epilepsy (CAE), show different electroclinical course than those not fulfilling CAE criteria. Methods In this multicenter retrospective study, we choose a fixed duration follow-up of 36 months to examine the electroclinical course of epilepsy in all children with TAS starting before 3 years of age. The probands who fulfilled Panayiotopoulos's criteria for CAE were classified as having pure early onset absence epilepsy (P-EOAE), whereas those who did not as nonpure EOAE (NP-EOAE). In addition, these two groups of patients were further stratified according to the number of antiepileptic drugs taken to obtain initial seizure control (mono-, bi-, and tritherapy). Key Findings Patients with P-EOAE (n = 111) showed earlier initial seizure control (p = 0.030) and better seizure-free survival curve (p = 0.004) than those with NP-EOAE (n = 77). No mutation in SLC2A1 gene or abnormal neuroimaging was observed in P-EOAE. Among patients with NP-EOAE, those receiving tritherapy showed increased risk of structural brain abnormalities (p = 0.001) or SLC2A1 mutations (p = 0.001) but fewer myoclonic features (p = 0.031) and worse seizure-free survival curve (p = 0.047) than those treated with mono- and bitherapy. Children with NP-EOAE had 2.134 the odds of having relapse during the follow-up compare to those with P-EOAE. Significance Children with early onset TAS who did meet Panayiotopoulos's criteria showed a favorable course of epilepsy, whereas patients not fulfilling Panayiotopoulos's criteria showed increased risk of relapse at long-term follow-up.

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KW - GLUT1 deficiency

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