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Epilepsy with generalized tonic-clonic seizures alone: Electroclinical features and prognostic patterns
Emanuele Cerulli Irelli1, Joanna Gesche2,3, Sophie Schlabitz4
1Department of Human Neurosciences, Sapienza University, Rome, Italy.
Epilepsy with generalized tonic-clonic seizures alone (GTCA) is manageable, with low drug resistance and early treatment response. However, some patients experience relapsing seizure control, requiring lifestyle guidance.
Area of Science:
- Neurology
- Epileptology
Background:
- Epilepsy with generalized tonic-clonic seizures alone (GTCA) is a common idiopathic generalized epilepsy (IGE) syndrome that remains poorly characterized.
- Understanding its electroclinical features, seizure outcomes, and antiseizure medication (ASM) withdrawal patterns is crucial for effective patient management.
Purpose of the Study:
- To investigate the electroclinical features, seizure outcomes, and ASM withdrawal in a large cohort of GTCA patients.
- To identify prognostic factors for drug resistance and successful ASM withdrawal in GTCA.
Main Methods:
- A multicenter retrospective study included 247 GTCA patients diagnosed using International League Against Epilepsy (2022) criteria.
- Data analyzed included prognostic patterns, drug resistance, ASM withdrawal, and associated prognostic factors.
Main Results:
- Drug resistance was observed in 16.3% of patients. Remission patterns varied, with 34.3% achieving early remission and 36.3% experiencing relapsing seizure control.
- Catamenial seizures and morning GTCS predominance predicted drug resistance. Successful ASM withdrawal was associated with longer seizure freedom duration.
Conclusions:
- GTCA is generally manageable with a low drug resistance rate and high early treatment response.
- A significant proportion of patients exhibit relapsing seizure control, necessitating tailored counseling and lifestyle recommendations.
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