Family history and frontal lobe seizures predict long-term remission in newly diagnosed cryptogenic focal epilepsy

Gasparini, Sara; Ferlazzo, Edoardo; Beghi, Ettore; Tripepi, Giovanni; Labate, Angelo; Mumoli, Laura; Leonardi, Cherry; Cianci, Vittoria; Latella, Maria Adele; Gambardella, Antonio; Aguglia, Umberto

doi:10.1016/j.eplepsyres.2013.07.004

Cited by 18 publications

(15 citation statements)

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“…Indeed, in many of our patients with both stroke and leukoaraiosis, epileptogenic focus was coherent with stroke, while epileptogenic role of leukoaraiosis seemed negligible. Moreover, in a study on cryptogenic focal epilepsy (Gasparini et al, 2013), the proportion of temporal lobe epilepsy was about 50%, very similar to our EAL group.…”

Section: Discussionsupporting

confidence: 74%

Epilepsy associated with Leukoaraiosis mainly affects temporal lobe: a casual or causal relationship?

et al. 2015

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Section: Discussionsupporting

confidence: 74%

Epilepsy associated with Leukoaraiosis mainly affects temporal lobe: a casual or causal relationship?

et al. 2015

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“…In previous studies on mixed cohorts of epilepsies, early age at onset has been reported as both a negative 23,27 and a positive 19,28,29 predictor. Because early-onset refractory SHE has been strongly associated with FCDs, particularly type IIb, 7,30 the finding of early age at onset as a possible negative predictor in our cohort could suggest that an additional number of nonlesional cases may have an underlying structural etiology.…”

Section: Discussionmentioning

confidence: 89%

Sleep-related hypermotor epilepsy

et al. 2017

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Objective:To assess the long-term outcome of sleep-related hypermotor epilepsy (SHE).Methods:We retrospectively reconstructed a representative cohort of patients diagnosed with SHE according to international diagnostic criteria, sleep-related seizures ≥75% and follow-up ≥5 years. Terminal remission (TR) was defined as a period of ≥5 consecutive years of seizure freedom at the last follow-up. We used Kaplan-Meier estimates to calculate the cumulative time-dependent probability of TR and to generate survival curves. Univariate and multivariate Cox regression analyses were performed.Results:We included 139 patients with a 16-year median follow-up (2,414 person-years). The mean age at onset was 13 ± 10 years. SHE was sporadic in 86% of cases and familial in 14%; 16% of patients had underlying brain abnormalities. Forty-five percent of patients had at least 1 seizure in wakefulness lifetime and 55% had seizures only in sleep (typical SHE). At the last assessment, 31 patients achieved TR (TR group, 22.3%), while 108 (NTR group, 77.7%) still had seizures or had been in remission for <5 years. The cumulative TR rate was 20.4%, 23.5%, and 28.4% by 10, 20, and 30 years from inclusion. At univariate analysis, any underlying brain disorder (any combination of intellectual disability, perinatal insult, pathologic neurologic examination, and brain structural abnormalities) and seizures in wakefulness were more frequent among the NTR group (p = 0.028; p = 0.043). Absence of any underlying brain disorder (hazard ratio 4.21, 95% confidence interval 1.26–14.05, p = 0.020) and typical SHE (hazard ratio 2.76, 95% confidence interval 1.31–5.85, p = 0.008) were associated with TR.Conclusions:Our data show a poor prognosis of SHE after a long-term follow-up. Its outcome is primarily a function of the underlying etiology.

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“…The remission rated lower than ours, which could be due to the stringent definition of early and late remission, as early remission was defined as a 2-year seizure control immediately after initial AED treatment, while late remission was defined as a 2-year seizure control achieved at least 24 months after treatment start. Moreover, an Italian study performed by Gasparini indicated only 23% patients with newly diagnosed cryptogenic focal epilepsy attained seizure remission during follow-up, as the remission was defined as the absence of any seizure for at least five years [13]. In a Chinese cohort of 180 patients [14], Zhang et al found early remission was reached in 69.4% newly diagnosed patients, and 10.6% entered late remission whereas 20% patients failed to achieve remission.…”

Section: Discussionmentioning

confidence: 98%

Factors predictive of late remission in a cohort of Chinese patients with newly diagnosed epilepsy

Shen

et al. 2016

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Family history and frontal lobe seizures predict long-term remission in newly diagnosed cryptogenic focal epilepsy

Cited by 18 publications

References 32 publications

Epilepsy associated with Leukoaraiosis mainly affects temporal lobe: a casual or causal relationship?

Epilepsy associated with Leukoaraiosis mainly affects temporal lobe: a casual or causal relationship?

Sleep-related hypermotor epilepsy

Factors predictive of late remission in a cohort of Chinese patients with newly diagnosed epilepsy

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