Severe myoclonic epilepsy in infancy: A systematic review and a meta-analysis of individual patient data

Behrouz Kassaï, Catherine Chiron, Ségolène Augier, Michel Cucherat, Elisabeth Rey, François Gueyffier, Renzo Guerrini, Julien Vincent, Olivier Dulac, Gérard Pons

Research output: Contribution to journalArticle

Abstract

Severe myoclonic epilepsy in infancy (SMEI) is a rare, but severe disorder with seizures typically resistant to conventional antiepileptic drugs. The objective of the present study was to systematically review the literature on the available treatments for SMEI. Databases searched included Medline, Embase, and Cochrane. We used a fixed effect model to summarize the odds ratio of seizures rates and a logistic model to evaluate the influence of patient characteristics on treatment effect. We found 23 uncontrolled studies and 2 randomized controlled trials (RCTs) that compared stiripentol with placebo. Overall, 64 children aged between 3 and 20 years were included in the two RCTs. The odds ratio of responding to stiripentol relative to placebo was 32 (CI: 6.2, 161) and stiripentol reduced seizure rate by 70% (93%; 47%). The multivariate analysis does not suggest any differences within subgroups of participants and cotherapy. Results of uncontrolled studies in children with SMEI are potentially biased and do not provide valid information on the benefits and harms of treatments. The two RCTs identified, however, were performed with the same objectives and design and showed that seizure frequency is greatly reduced by stiripentol in children with SMEI after 2 months of treatment.

Original languageEnglish
Pages (from-to)343-348
Number of pages6
JournalEpilepsia
Volume49
Issue number2
DOIs
Publication statusPublished - Feb 2008

Keywords

  • Meta-analysis
  • Pediatrics
  • Severe myoclonic epilepsy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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    Kassaï, B., Chiron, C., Augier, S., Cucherat, M., Rey, E., Gueyffier, F., Guerrini, R., Vincent, J., Dulac, O., & Pons, G. (2008). Severe myoclonic epilepsy in infancy: A systematic review and a meta-analysis of individual patient data. Epilepsia, 49(2), 343-348. https://doi.org/10.1111/j.1528-1167.2007.01423.x