Symptomatic and presumed symptomatic focal epilepsies in childhood: An observational, prospective multicentre study

Marilena Vecchi, Carmen Barba, Debora De Carlo, Micol Stivala, Renzo Guerrini, Emilio Albamonte, Domiziana Ranalli, Domenica Battaglia, Giada Lunardi, Clementina Boniver, Benedetta Piccolo, Francesco Pisani, Gaetano Cantalupo, Giuliana Nieddu, Susanna Casellato, Silvia Cappanera, Elisabetta Cesaroni, Nelia Zamponi, Domenico Serino, Lucia FuscoAlessandro Iodice, Filippo Palestra, Lucio Giordano, Elena Freri, Ilaria De Giorgi, Francesca Ragona, Tiziana Granata, Isabella Fiocchi, Stefania Maria Bova, Massimo Mastrangelo, Alberto Verrotti, Sara Matricardi, Elena Fontana, Davide Caputo, Francesca Darra, Bernardo Dalla Bernardina, Francesca Beccaria, Giuseppe Capovilla, Maria Giuseppina Baglietto, Alessandra Gagliardi, Aglaia Vignoli, Maria Paola Canevini, Egle Perissinotto, Stefano Francione

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: To describe the clinical, neuropsychological, and psychopathologic features of a cohort of children with a new diagnosis of symptomatic or presumed symptomatic focal epilepsy at time of recruitment and through the first month. The selected population will be followed for 2–5 years after enrollment to investigate the epilepsy course and identify early predictors of drug resistance. Methods: In this observational, multicenter, nationwide study, children (age 1 month–12.9 years) with a new diagnosis of symptomatic or presumed symptomatic focal epilepsy were consecutively enrolled in 15 Italian tertiary childhood epilepsy centers. Inclusion criteria were as follows: (1) diagnosis of symptomatic focal epilepsy due to acquired and developmental etiologies, and presumed symptomatic focal epilepsy; (2) age at diagnosis older than 1 month and <13 years; and (3) written informed consent. Children were subdivided into three groups: ≤3 years, >3 to 6 years, and >6 years. Clinical, electroencephalography (EEG), neuroimaging, and neuropsychological variables were identified for statistical analyses. Results: Two hundred fifty-nine children were enrolled (116 female and 143 male). Median age: 4.4 years (range 1 month–12.9 years); 46.0% (n = 119) of children were younger than 3 years, 24% (61) from 3 to 6 years of age, and 30% (79) older than 6 years. Neurologic examination findings were normal in 71.8%. Brain magnetic resonance imaging (MRI) was abnormal in 59.9%. Children age ≤3 years experienced the highest seizure frequency in the first month after recruitment (p < 0.0001). Monotherapy in the first month was used in 67.2%. Cognitive tests at baseline revealed abnormal scores in 30%; behavioral problems were present in 21%. At multivariate analysis, higher chances to exhibit more than five seizures in the first month after epilepsy onset was confirmed for younger children and those with temporal lobe epilepsy. Significance: In this prospective cohort study, an extensive characterization of epilepsy onset in children with symptomatic or presumed symptomatic focal epilepsies is reported in relation to the age group and the localization of the epileptogenic zone.

Original languageEnglish
Pages (from-to)1808-1816
Number of pages9
JournalEpilepsia
Volume57
Issue number11
DOIs
Publication statusPublished - Nov 1 2016

Fingerprint

Partial Epilepsy
Multicenter Studies
Prospective Studies
Epilepsy
Seizures
Temporal Lobe Epilepsy
Neurologic Examination
Neurologic Manifestations
Drug Resistance
Neuroimaging
Electroencephalography
Cohort Studies
Multivariate Analysis
Age Groups
Magnetic Resonance Imaging
Brain
Population

Keywords

  • Behavior impairment
  • Childhood epilepsy
  • Cognitive function
  • Focal symptomatic seizures
  • Intractable epilepsy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Vecchi, M., Barba, C., De Carlo, D., Stivala, M., Guerrini, R., Albamonte, E., ... Francione, S. (2016). Symptomatic and presumed symptomatic focal epilepsies in childhood: An observational, prospective multicentre study. Epilepsia, 57(11), 1808-1816. https://doi.org/10.1111/epi.13574

Symptomatic and presumed symptomatic focal epilepsies in childhood : An observational, prospective multicentre study. / Vecchi, Marilena; Barba, Carmen; De Carlo, Debora; Stivala, Micol; Guerrini, Renzo; Albamonte, Emilio; Ranalli, Domiziana; Battaglia, Domenica; Lunardi, Giada; Boniver, Clementina; Piccolo, Benedetta; Pisani, Francesco; Cantalupo, Gaetano; Nieddu, Giuliana; Casellato, Susanna; Cappanera, Silvia; Cesaroni, Elisabetta; Zamponi, Nelia; Serino, Domenico; Fusco, Lucia; Iodice, Alessandro; Palestra, Filippo; Giordano, Lucio; Freri, Elena; De Giorgi, Ilaria; Ragona, Francesca; Granata, Tiziana; Fiocchi, Isabella; Bova, Stefania Maria; Mastrangelo, Massimo; Verrotti, Alberto; Matricardi, Sara; Fontana, Elena; Caputo, Davide; Darra, Francesca; Dalla Bernardina, Bernardo; Beccaria, Francesca; Capovilla, Giuseppe; Baglietto, Maria Giuseppina; Gagliardi, Alessandra; Vignoli, Aglaia; Canevini, Maria Paola; Perissinotto, Egle; Francione, Stefano.

In: Epilepsia, Vol. 57, No. 11, 01.11.2016, p. 1808-1816.

Research output: Contribution to journalArticle

Vecchi, M, Barba, C, De Carlo, D, Stivala, M, Guerrini, R, Albamonte, E, Ranalli, D, Battaglia, D, Lunardi, G, Boniver, C, Piccolo, B, Pisani, F, Cantalupo, G, Nieddu, G, Casellato, S, Cappanera, S, Cesaroni, E, Zamponi, N, Serino, D, Fusco, L, Iodice, A, Palestra, F, Giordano, L, Freri, E, De Giorgi, I, Ragona, F, Granata, T, Fiocchi, I, Bova, SM, Mastrangelo, M, Verrotti, A, Matricardi, S, Fontana, E, Caputo, D, Darra, F, Dalla Bernardina, B, Beccaria, F, Capovilla, G, Baglietto, MG, Gagliardi, A, Vignoli, A, Canevini, MP, Perissinotto, E & Francione, S 2016, 'Symptomatic and presumed symptomatic focal epilepsies in childhood: An observational, prospective multicentre study', Epilepsia, vol. 57, no. 11, pp. 1808-1816. https://doi.org/10.1111/epi.13574
Vecchi M, Barba C, De Carlo D, Stivala M, Guerrini R, Albamonte E et al. Symptomatic and presumed symptomatic focal epilepsies in childhood: An observational, prospective multicentre study. Epilepsia. 2016 Nov 1;57(11):1808-1816. https://doi.org/10.1111/epi.13574
Vecchi, Marilena ; Barba, Carmen ; De Carlo, Debora ; Stivala, Micol ; Guerrini, Renzo ; Albamonte, Emilio ; Ranalli, Domiziana ; Battaglia, Domenica ; Lunardi, Giada ; Boniver, Clementina ; Piccolo, Benedetta ; Pisani, Francesco ; Cantalupo, Gaetano ; Nieddu, Giuliana ; Casellato, Susanna ; Cappanera, Silvia ; Cesaroni, Elisabetta ; Zamponi, Nelia ; Serino, Domenico ; Fusco, Lucia ; Iodice, Alessandro ; Palestra, Filippo ; Giordano, Lucio ; Freri, Elena ; De Giorgi, Ilaria ; Ragona, Francesca ; Granata, Tiziana ; Fiocchi, Isabella ; Bova, Stefania Maria ; Mastrangelo, Massimo ; Verrotti, Alberto ; Matricardi, Sara ; Fontana, Elena ; Caputo, Davide ; Darra, Francesca ; Dalla Bernardina, Bernardo ; Beccaria, Francesca ; Capovilla, Giuseppe ; Baglietto, Maria Giuseppina ; Gagliardi, Alessandra ; Vignoli, Aglaia ; Canevini, Maria Paola ; Perissinotto, Egle ; Francione, Stefano. / Symptomatic and presumed symptomatic focal epilepsies in childhood : An observational, prospective multicentre study. In: Epilepsia. 2016 ; Vol. 57, No. 11. pp. 1808-1816.
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T1 - Symptomatic and presumed symptomatic focal epilepsies in childhood

T2 - An observational, prospective multicentre study

AU - Vecchi, Marilena

AU - Barba, Carmen

AU - De Carlo, Debora

AU - Stivala, Micol

AU - Guerrini, Renzo

AU - Albamonte, Emilio

AU - Ranalli, Domiziana

AU - Battaglia, Domenica

AU - Lunardi, Giada

AU - Boniver, Clementina

AU - Piccolo, Benedetta

AU - Pisani, Francesco

AU - Cantalupo, Gaetano

AU - Nieddu, Giuliana

AU - Casellato, Susanna

AU - Cappanera, Silvia

AU - Cesaroni, Elisabetta

AU - Zamponi, Nelia

AU - Serino, Domenico

AU - Fusco, Lucia

AU - Iodice, Alessandro

AU - Palestra, Filippo

AU - Giordano, Lucio

AU - Freri, Elena

AU - De Giorgi, Ilaria

AU - Ragona, Francesca

AU - Granata, Tiziana

AU - Fiocchi, Isabella

AU - Bova, Stefania Maria

AU - Mastrangelo, Massimo

AU - Verrotti, Alberto

AU - Matricardi, Sara

AU - Fontana, Elena

AU - Caputo, Davide

AU - Darra, Francesca

AU - Dalla Bernardina, Bernardo

AU - Beccaria, Francesca

AU - Capovilla, Giuseppe

AU - Baglietto, Maria Giuseppina

AU - Gagliardi, Alessandra

AU - Vignoli, Aglaia

AU - Canevini, Maria Paola

AU - Perissinotto, Egle

AU - Francione, Stefano

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Objective: To describe the clinical, neuropsychological, and psychopathologic features of a cohort of children with a new diagnosis of symptomatic or presumed symptomatic focal epilepsy at time of recruitment and through the first month. The selected population will be followed for 2–5 years after enrollment to investigate the epilepsy course and identify early predictors of drug resistance. Methods: In this observational, multicenter, nationwide study, children (age 1 month–12.9 years) with a new diagnosis of symptomatic or presumed symptomatic focal epilepsy were consecutively enrolled in 15 Italian tertiary childhood epilepsy centers. Inclusion criteria were as follows: (1) diagnosis of symptomatic focal epilepsy due to acquired and developmental etiologies, and presumed symptomatic focal epilepsy; (2) age at diagnosis older than 1 month and <13 years; and (3) written informed consent. Children were subdivided into three groups: ≤3 years, >3 to 6 years, and >6 years. Clinical, electroencephalography (EEG), neuroimaging, and neuropsychological variables were identified for statistical analyses. Results: Two hundred fifty-nine children were enrolled (116 female and 143 male). Median age: 4.4 years (range 1 month–12.9 years); 46.0% (n = 119) of children were younger than 3 years, 24% (61) from 3 to 6 years of age, and 30% (79) older than 6 years. Neurologic examination findings were normal in 71.8%. Brain magnetic resonance imaging (MRI) was abnormal in 59.9%. Children age ≤3 years experienced the highest seizure frequency in the first month after recruitment (p < 0.0001). Monotherapy in the first month was used in 67.2%. Cognitive tests at baseline revealed abnormal scores in 30%; behavioral problems were present in 21%. At multivariate analysis, higher chances to exhibit more than five seizures in the first month after epilepsy onset was confirmed for younger children and those with temporal lobe epilepsy. Significance: In this prospective cohort study, an extensive characterization of epilepsy onset in children with symptomatic or presumed symptomatic focal epilepsies is reported in relation to the age group and the localization of the epileptogenic zone.

AB - Objective: To describe the clinical, neuropsychological, and psychopathologic features of a cohort of children with a new diagnosis of symptomatic or presumed symptomatic focal epilepsy at time of recruitment and through the first month. The selected population will be followed for 2–5 years after enrollment to investigate the epilepsy course and identify early predictors of drug resistance. Methods: In this observational, multicenter, nationwide study, children (age 1 month–12.9 years) with a new diagnosis of symptomatic or presumed symptomatic focal epilepsy were consecutively enrolled in 15 Italian tertiary childhood epilepsy centers. Inclusion criteria were as follows: (1) diagnosis of symptomatic focal epilepsy due to acquired and developmental etiologies, and presumed symptomatic focal epilepsy; (2) age at diagnosis older than 1 month and <13 years; and (3) written informed consent. Children were subdivided into three groups: ≤3 years, >3 to 6 years, and >6 years. Clinical, electroencephalography (EEG), neuroimaging, and neuropsychological variables were identified for statistical analyses. Results: Two hundred fifty-nine children were enrolled (116 female and 143 male). Median age: 4.4 years (range 1 month–12.9 years); 46.0% (n = 119) of children were younger than 3 years, 24% (61) from 3 to 6 years of age, and 30% (79) older than 6 years. Neurologic examination findings were normal in 71.8%. Brain magnetic resonance imaging (MRI) was abnormal in 59.9%. Children age ≤3 years experienced the highest seizure frequency in the first month after recruitment (p < 0.0001). Monotherapy in the first month was used in 67.2%. Cognitive tests at baseline revealed abnormal scores in 30%; behavioral problems were present in 21%. At multivariate analysis, higher chances to exhibit more than five seizures in the first month after epilepsy onset was confirmed for younger children and those with temporal lobe epilepsy. Significance: In this prospective cohort study, an extensive characterization of epilepsy onset in children with symptomatic or presumed symptomatic focal epilepsies is reported in relation to the age group and the localization of the epileptogenic zone.

KW - Behavior impairment

KW - Childhood epilepsy

KW - Cognitive function

KW - Focal symptomatic seizures

KW - Intractable epilepsy

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