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Published on: September 20, 2024
[Absence epilepsy. A review of our 14 years' experience]
T Ureña-Hornos1, R Rubio-Rubio, D Gros-Esteban
1Servicio de Neuropediatría, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Insights
Absence epilepsy (AE) in children is typically diagnosed and treated effectively, with most patients achieving remission. Early expert management and attention to associated learning issues are crucial for long-term outcomes.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Neuroscience
Context:
- Absence epilepsy (AE) is a common childhood epilepsy characterized by brief episodes of impaired consciousness and generalized spike-wave discharges on EEG.
- Effective management strategies are essential to prevent long-term neurological and developmental consequences.
Purpose:
- To evaluate the long-term outcomes and treatment response in a cohort of children diagnosed with absence epilepsy.
- To identify factors associated with successful remission and persistent symptoms.
Summary:
- This study reviewed 49 pediatric cases of absence epilepsy, identifying a 10% prevalence within a larger epilepsy cohort.
- Most children achieved remission, with 42 out of 49 being seizure-free for over six months, including 21 off medication.
- Two females on treatment remained the only ones with ongoing absences, highlighting treatment efficacy.
Impact:
- Absence epilepsy is generally manageable with appropriate treatment, often responding to monotherapy or combination antiepileptic drugs.
- Prompt diagnosis and expert management by neurologists are key to achieving sustained seizure control.
- Associated psychosocial and learning difficulties in children with AE necessitate comprehensive, multidisciplinary care.
Introduction:
Absence epilepsy (AE), typically occurring at the paediatric age, is characterised by episodes of diminished consciousness accompanied by a generalised rapid spike-wave in electroencephalogram recordings.
Patients And Methods:
Our study involved children with AE from the Neuropaediatrics database between May 1990 and May 2004. Patient records were reviewed and cases no longer controlled were contacted by telephone.
Results:
Of a total of 7,562 patients surveyed in the period under study, 757 subjects (10%) had epilepsy and there were 49 cases of AE (6.47% of the total number of cases of epilepsy): 29 were females (59.2%) and 20 were males (40.8%). Mean age at the time of the first visit was 7.93 years (ranging between 3 years and 10 months and 13 years and 6 months). The average follow-up time between the first visit and the last time information was updated was 5.3 years (ranging between 10 days and 13 years and 2 months). Only two females, receiving treatment, still have absences. 42 children have been without absences for more than six months, 16 with treatment and 26 without therapy; 21 children have been without absences for over four years and are not under treatment. 12 have problems at school.
Conclusions:
AE is easy to diagnose and usually responds well to treatment either as monotherapy or, in some cases, in association with two antiepileptic agents. Strict initial control by experts in its management prevents absences from continuing over long periods of time. The psychosocial and learning dysfunctions that are associated in some cases require close attention.
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