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Long-term seizure outcome in patients with juvenile absence epilepsy; a retrospective study in a tertiary referral
Pavlína Danhofer1, Milan Brázdil2, Hana Ošlejšková1
1Epilepsy Center Brno, Department of Child Neurology, University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Insights
Juvenile absence epilepsy (JAE) often leads to poor seizure control and drug resistance, with outcomes remaining uncertain despite various treatments. This study highlights challenges in managing JAE pharmacotherapy over five years.
Area of Science:
- Neurology
- Epileptology
- Pharmacology
Background:
- Juvenile absence epilepsy (JAE) is a challenging epilepsy syndrome.
- Understanding long-term outcomes and treatment efficacy is crucial for patient management.
Purpose of the Study:
- To evaluate pharmacotherapy effects and long-term seizure outcomes in Juvenile Absence Epilepsy (JAE) over a five-year period.
- To identify historical patient factors influencing seizure control in JAE.
Main Methods:
- Retrospective study of 46 JAE patients (2006-2011).
- Analysis of seizure onset, seizure types, family history, status epilepticus, and medication history.
- Evaluation of seizure control rates over a five-year follow-up.
Main Results:
- Seizure freedom achieved in only 15.2% of patients.
- Nearly half (47.8%) experienced very poor seizure control or drug resistance.
- Average of 3.8 antiepileptic drugs used per patient.
Conclusions:
- JAE is associated with a high rate of pharmacoresistance and poor seizure control in a significant portion of patients.
- The long-term prognosis for JAE remains uncertain.
- Further research into effective JAE treatments is warranted.
Purpose:
The study aim was to evaluate pharmacotherapy effects and long-term seizure outcomes in patients with juvenile absence epilepsy (JAE) during a five-year follow-up period. The secondary aim was to identify factors from patient history and determine their influence on seizure control.
Method:
We retrospectively studied 46 patients with JAE in the period between 2006 and 2011. The age at seizure onset, onset seizure type, family history of epilepsy, status epilepticus in history, medication history, and the rate of seizure control were studied.
Results:
There were 30 females (65.2%) and 16 males (34.8%) in the study. The mean age at seizure onset was 12.9±5.6 years (ranged from 3 to 28 years). In 30 patients (65.2%), seizure onset was with absences, in 15 patients (32.6%) with generalized tonic-clonic seizure (GTCS), and in 1 patient (2.2%) with absence status. In 43 patients (93.5%), GTCS occurred in the course of the disease. Family history for epilepsy was positive in 10 patients (21.7%). In the five-year follow-up period, seizure freedom (Group 1) was achieved in 7 patients (15.2%). In total, 22 patients (47.8%) were classified into the groups involving very poor seizure control and antiepileptic drug resistance (Groups 5 and 6). The mean number of antiepileptic drugs (AEDs) used in the course of the disease in appropriate therapeutic doses was 3.8±2.3 (1-10 AEDs).
Conclusion:
The study results show that almost half of JAE patients have poor seizure control with a high rate of pharmacoresistance. The outcome of JAE can be very uncertain.
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