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First-drug treatment failures in children with typical absence epilepsy
Faruk Incecik1, Sakir Altunbasak1, Ozlem M Herguner1
1Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Cukurova University, Adana, Turkey.
Insights
Photoconvulsive EEG response is a key predictor of treatment failure in childhood absence epilepsy (CAE). Understanding these factors helps optimize antiepileptic drug (AED) selection for better outcomes.
Area of Science:
- Pediatric Neurology
- Epileptology
Background:
- Childhood absence epilepsy (CAE) is a common epilepsy syndrome in children.
- Characterized by frequent typical absence seizures.
- Typically responds well to initial antiepileptic drug (AED) monotherapy.
Purpose of the Study:
- To identify risk factors for initial antiepileptic drug (AED) treatment failure in children with CAE.
- To improve treatment strategies for pediatric epilepsy.
Main Methods:
- Survival analysis of predictive factors in 52 children diagnosed with CAE.
- Univariate and multivariate analyses were performed.
Main Results:
- The study included 52 children (61.5% girls), with a mean age of seizure onset at 6.5 years.
- 80.8% of patients responded to the first AED (Group A), while 19.2% did not (Group B).
- Univariate analysis identified age of seizure onset, coexisting seizure types, and photoconvulsive EEG response as significant predictors of failure. Multivariate analysis confirmed photoconvulsive EEG response as the sole significant risk factor.
Conclusions:
- Photoconvulsive EEG response is a significant predictor of poor response to initial AED treatment in children with CAE.
- Age of seizure onset and coexisting seizure types also showed associations in univariate analysis.
- Identifying these factors can guide more personalized and effective epilepsy management.
Background:
Childhood absence epilepsy (CAE) is a well-known syndrome with onset in middle childhood and is characterized by multiple typical absences per day. Pharmacological treatment is specific and usually successful with a single medication. The goal of the study was to assess on risk factors associated with failure to respond to the initial antiepileptic drug (AED).
Methods:
Fifty-two children with CAE were enrolled. Predictive factors were analyzed by survival methods.
Results:
Among 52 patients, 32 patients (61.5%) were girls and the remaining 20 (38.5%) were boys and the mean age at the seizure onset was 6.5±1.78 years old (3-11.5 years). Of the 52 patients, 42 (80.8%) were treated relatively successfully with the first AED treatment (Group A), and 10 (19.2%) were not responsed (Group B). Age of seizure onset, coexisting other types of seizures, and photoconvulsive EEG response were significantly associated with failure risk according to univariate analysis. In the multivariate analysis, only photoconvulsive EEG response was the risk factor influencing poor response to initial AED treatment.
Conclusion:
Factors predicting failure to respond to the AED were age of seizure onset, coexisting other types of seizures, and photoconvulsive EEG response in children with CAE.
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