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[The prognosis of epilepsy in children with generalized spikes and wave disc charges in electroencephalographic
B Martínez-Menéndez1, A P Sempere, P de la Peña
1Unidad de Neurología Pediátrica, Hospital Universitario de Getafe, España.
Insights
The prognosis for children with epilepsy and generalized spike-and-wave discharges (P-O) on EEG is generally good, with 78% becoming seizure-free. However, specific factors like abnormal pregnancy or certain seizure types can influence outcomes.
Area of Science:
- Neurology
- Pediatrics
- Epileptology
Context:
- Epilepsy is a chronic neurological disorder with varied prognoses.
- The long-term outlook for pediatric epilepsy characterized by generalized spike-and-wave discharges (P-O) on electroencephalogram (EEG) has been largely undetermined.
- Understanding prognosis is crucial for effective management and patient counseling.
Purpose:
- To ascertain the prognosis of childhood epilepsy associated with P-O on EEG.
- To identify specific clinical and electroencephalographic factors influencing seizure remission and recurrence in this pediatric population.
Summary:
- A decade-long review of 39,322 EEGs identified pediatric epilepsy patients under 14.
- Seventy-eight percent of children achieved seizure freedom.
- Factors associated with favorable outcomes included absence of seizures, while abnormal pregnancy, West syndrome, learning difficulties, specific seizure types, and certain EEG patterns (hypsarrhythmia, rapid P-O) were linked to poorer prognoses.
- Recurrence was observed in 31.4% upon medication cessation.
- Family history of epilepsy and rapid P-O on EEG emerged as risk factors.
Impact:
- Provides valuable prognostic information for pediatric epilepsy with P-O discharges.
- Highlights modifiable and non-modifiable factors influencing seizure control.
- Informs clinical decision-making and genetic counseling for affected families.
Introduction:
Epilepsy is a chronic disorder. The prognosis of one particular subtype, that of children with generalized spike and wave discharges (P-O) on the electroencephalogram (EEG), is unknown.
Objective:
To determine the prognosis of children with epilepsy with P-O on EEG and the factors which affect this.
Patients And Methods:
All EEGs done over ten years (39,322) were reviewed, and the epileptic patients under 14 years old identified. Absence and recurrence of crises were evaluated and the factors influencing them analyzed. Minimum significance was p < 0.05. The chi square test, Student's t test and Kaplan-Meier method were used. Logistic regression models were devised.
Results:
Of the children studied, 78% became crisis-free. After monovariant and multivariant analysis the only conditions which fitted the regression models were: abnormal pregnancy; West syndrome or learning difficulties; having certain types of crises, myoclonic, clonic-tonic, partial simple or complex crises; a normal EEG with hypsarrhythmia, slow or fast P-O and requiring multiple medication. When medication ceased, 31.4% had recurrence of the episodes. On monovariant and multivariant analysis, protective factors were absence of attacks and risk factors were a family history of epilepsy or an EEG with rapid P-O.
Conclusions:
The overall prognosis for epileptic children with P-O is good. There are factors which improve or worsen the pronosis, but these cannot be modified.
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