Refractory absence seizures: An Italian multicenter retrospective study

Area of Science:

• Neurology
• Pediatric Epilepsy

Background:

• Refractory absence seizures present diagnostic and prognostic challenges.
• Evaluating the long-term outcomes of drug-resistant absence seizures is crucial.

Purpose of the Study:

• To assess the evidence and prognosis in pediatric patients with refractory absence seizures.
• To identify factors associated with seizure control and cognitive outcomes.

Main Methods:

• Retrospective analysis of 92 subjects with drug-resistant absence seizures across 17 Italian pediatric epilepsy centers.
• Data collected included age at onset, family history, seizure characteristics, antiepileptic drug (AED) treatments, electroencephalography (EEG), and neuropsychological assessments.
• Statistical analysis (chi-square test) compared subgroups with ongoing seizures versus seizure freedom.

Main Results:

• Nearly half (49%) of subjects continued to experience absence seizures, while 51% achieved seizure freedom.
• No correlation was found between age of onset, family history, or EEG abnormalities and seizure outcomes.
• Significant differences emerged regarding the number of AEDs used and the presence of intellectual disability between the groups.

Conclusions:

• Childhood Absence Epilepsy, particularly when refractory, may not be as benign as previously thought.
• Longer disease duration and higher seizure frequency are linked to increased cognitive impairment.
• No clear risk factors were identified for predicting worse prognosis, indicating a need for further research.