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Patterns of Response to Treatment and Outcome of Childhood Absence Epilepsy: A Multicenter Study From Saudi Arabia
Raghad Shiraz Alharthi1, Muhammad Talal Alrifai2, Raghad Darwish Alomari1
1Division of Pediatric Neurology, Department of Pediatrics, King Abdullah Specialist Children's Hospital (KASCH), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia.
Insights
Childhood absence epilepsy (CAE) in Saudi Arabia shows good treatment response rates with monotherapy. Early diagnosis and treatment are key to improving outcomes and reducing recurrence risk in pediatric epilepsy patients.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Outcomes Research
Background:
- Childhood absence epilepsy (CAE) is a common pediatric epilepsy syndrome.
- While often considered benign, pharmaco-resistance and neuropsychiatric issues affect a notable proportion of patients.
- This study investigates CAE patient outcomes in Saudi Arabian tertiary care centers.
Purpose of the Study:
- To evaluate the treatment response and remission rates in pediatric patients diagnosed with Childhood Absence Epilepsy (CAE).
- To identify factors influencing outcomes, such as comorbidities and age at diagnosis.
- To assess the effectiveness of monotherapy in managing CAE in a Saudi Arabian cohort.
Main Methods:
- Retrospective cohort study involving 61 pediatric patients (≤14 years) with confirmed CAE diagnosis.
- Data collected from electronic medical records across multiple Saudi Arabian tertiary care centers.
- Treatment response defined as >50% seizure reduction; terminal remission as one-year seizure-free off medication.
Main Results:
- High treatment response rate (88.5%) observed with appropriate antiseizure medications, predominantly monotherapy (93.4%).
- Valproic acid (60.7%) and ethosuximide (36.1%) were the most common first-line treatments.
- Terminal remission achieved in 27.8% of responders; 11.5% showed no response. Isolated staring was the main presentation (88.5%).
Conclusions:
- Pediatric patients with CAE in Saudi Arabia exhibit favorable outcomes with high response rates to monotherapy.
- Early diagnosis and intervention appear crucial for better prognosis, with a trend towards higher recurrence in later-diagnosed cases.
- Monotherapy is effective for most CAE cases, highlighting the importance of timely management.
Background:
Childhood absence epilepsy (CAE) is a common pediatric epilepsy syndrome affecting school-aged children. While generally considered benign, recent studies indicate that a significant proportion of patients experience pharmaco-resistance and neuropsychiatric comorbidities. This study aimed to investigate the outcomes of CAE patients across tertiary care centers in Saudi Arabia.
Methods:
A retrospective cohort study was conducted at multiple tertiary care centers in Saudi Arabia. The study included 61 pediatric patients (≤14 years) with confirmed CAE diagnosis. Data were collected from electronic medical records. Response to treatment was defined as >50% reduction in seizure frequency from the baseline, while terminal remission was defined as one-year seizure-free off antiseizure medications.
Results:
The study population had an equal gender distribution (50.8% male) with a median age of 7 years at diagnosis. Most patients (93.4%) had no comorbidities. The majority (88.5%) achieved response to appropriate antiseizure medications; of these responders, 27.8% achieved terminal remission, while 11.5% demonstrated no response. Isolated staring episodes were the predominant presentation (88.5%). Most patients (93.4%) were managed with monotherapy, with valproic acid (60.7%) being the most commonly prescribed medication, followed by ethosuximide (36.1%). Age at diagnosis showed a positive association with recurrence risk, though not statistically significant.
Conclusions:
CAE patients in Saudi Arabian tertiary care centers demonstrate favorable outcomes, with high response rates with monotherapy. Early diagnosis and treatment may improve prognosis, as suggested by the trend toward higher recurrence rates in patients diagnosed at older ages.
