Epilepsy syndromes in patients with childhood-onset seizures in Finland

Sillanpää, Matti; Jalava, Merja; Shinnar, Shlomo

doi:10.1016/s0887-8994(99)00031-4

Cited by 94 publications

(86 citation statements)

References 17 publications

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“…It seems that LGS is often not apparent at diagnosis but evolves over time (15,23). Only four (0.9%) of the 462 children in the Dutch study (33), four (0.7%) of the 613 children in the cohort of Connecticut (19), and four (3%) of the 150 children in a Finnish study were classified as LGS (34).…”

Section: Discussionmentioning

confidence: 99%

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Newly Diagnosed Unprovoked Epileptic Seizures: Presentation at Diagnosis in CAROLE Study

Jallon¹,

Loiseau²,

Loiseau³

2001

Epilepsia

214

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Summary:Purpose: We describe first unprovoked seizures and newly diagnosed epilepsies at initial presentation, with a special emphasis on epilepsy syndromes, in a large cohort recruited in the mid-1990s in France.Methods: The French Foundation for Research on Epilepsy set up a network to conduct a prospective study of patients with newly diagnosed unprovoked seizures. Information was provided by 243 child or adult neurologists. Four neurologists classified each case according to the International League Against Epilepsy (ILAE) criteria. First-seizure patients and patients with previously undiagnosed seizures were compared.Results: Between May 1, 1995, and June 30, 1996, 1,942 patients aged from 1 month to 95 years were identified: 926 (47.7%) with a single seizure and 1,016 (52.3%) with newly diagnosed epilepsy. All but 17 patients had EEGs. In the firstseizure and newly-diagnosed-epilepsy groups, neuroimaging studies were performed in 78.2 and 68.3% of patients, and medication prescribed in 54.1 and 89.6%, respectively. There were significant differences between the two groups with respect to age at onset and diagnosis, sex, etiology, several specific syndromes, as well as the type and presentation of initial seizure. In patients for whom the first seizure was convulsive, only sex, multiple seizures in a day or status epilepticus, and cryptogenic localization-related syndrome differed between the two groups.Conclusions: Approximately half of patients who first came to attention for an unprovoked seizure already met epidemiologic criteria for epilepsy. There were significant differences between the types of patients with a first seizure and those with newly diagnosed epilepsy. One or several seizures at diagnosis did not influence the diagnostic assessment of the patients but had a strong influence on the initiation of treatment.

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Section: Discussionmentioning

confidence: 99%

“…Clearly, investigators who have addressed this issue previously recognized this dilemma and resolved it differently (16,19,23,33,34). Further discussion among investigators in this field is necessary to reach a consensus on this definitional issue for which the two Commission statements are at odds.…”

Section: Discussionmentioning

confidence: 99%

Newly Diagnosed Unprovoked Epileptic Seizures: Presentation at Diagnosis in CAROLE Study

Jallon¹,

Loiseau²,

Loiseau³

2001

Epilepsia

214

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“…However, rather than using a model based on these variables, syndromic classification is an accurate way to predict intractability by identifying early the various severe epilepsy syndromes. Accurate classification of children with newly diagnosed epilepsy into epilepsy syndromes has repeatedly proved to be feasible in >90% of cases (18,(86)(87)(88). Syndromes that carry the highest risk of refractoriness and are recognizable early include Ohtahara syndrome in neonates (89), West syndrome and severe myoclonic epilepsy in infants (90,91), myoclonic-astatic epilepsy (92), Lennox-Gastaut syndrome (93), Rasmussen encephalitis (94), and partial epilepsies due to malformations of cortical development whatever the age (95).…”

Section: Pediatric Issuesmentioning

confidence: 99%

Is Refractory Epilepsy Preventable?

et al. 2002

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Summary: About a third of the patients diagnosed with epilepsy will not be fully controlled with antiepileptic drugs (AEDs), and many of them will have frequent and disabling seizures. These patients will undergo multiple drug trials, most often without complete seizure remission. Moreover, refractory epilepsy is associated with increased morbidity (from seizures and medications), social isolation, unemployment, and overall reduced quality of life. There is evidence that refractory epilepsy can be a progressive disorder, which, if controlled early, might never develop into a full syndrome with all of its associated sequelae. The difficulty lies in identifying at an early stage patients who are likely to progress to intractability. No currently known markers enable clinicians to make this identification with confidence. Advances in pharmacogenomics and our understanding of pharmacologic responsiveness in epilepsy may change this situation. Even now, we are able to identify many patients with a poor prognosis earlier than before, particularly in the pediatric population, in which syndromic classification may provide an approach to predict intractability. The early initiation of aggressive therapy may improve outcome and overall quality of life.

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“…В 3 крупных исследовани-ях, проведенных с использованием классификации 1989 г., нет данных по синдрому Панайотопулоса [19,37,38]. Таким образом, для оценки частоты встречае-мости синдрома необходимо пользоваться результата-ми повседневного опыта практикующих эпилептоло-гов, работающих с детьми.…”

Section: эпидемиологияunclassified