Long-term prognosis for childhood and juvenile absence epilepsy

Trinka, Eugen; Baumgartner, Sarah; Unterberger, Iris; Unterrainer, Josef M.; Luef, Gerhard; Haberlandt, Edda; Bauer, Gerhard

doi:10.1007/s00415-004-0521-1

Cited by 114 publications

(128 citation statements)

References 23 publications

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“…Our current understanding suggests that in the majority of these children, seizures will remit in adolescence and they will enter adulthood seizure-free off medications. 39,40 Less is known about what happens to the attentional difficulties and whether academic achievement worsens. A limitation of this study is its inability to address whether the presence of a baseline attention problem is associated with a worse long-term seizure prognosis.…”

Section: Statistical Analysis Baseline Neurocognitive Test Results Amentioning

confidence: 99%

Pretreatment cognitive deficits and treatment effects on attention in childhood absence epilepsy

et al. 2013

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Objective: To determine the neurocognitive deficits associated with newly diagnosed untreated childhood absence epilepsy (CAE), develop a model describing the factorial structure of items measuring academic achievement and 3 neuropsychological constructs, and determine shortterm differential neuropsychological effects on attention among ethosuximide, valproic acid, and lamotrigine.Methods: Subjects with newly diagnosed CAE entering a double-blind, randomized controlled clinical trial had neuropsychological testing including assessments of general intellectual functioning, attention, memory, executive function, and achievement. Attention was reassessed at the week 16-20 visit.Results: At study entry, 36% of the cohort exhibited attention deficits despite otherwise intact neurocognitive functioning. Structural equation modeling of baseline neuropsychological data revealed a direct sequential effect among attention, memory, executive function, and academic achievement. At the week 16-20 visit, attention deficits persisted even if seizure freedom was attained. More subjects receiving valproic acid (49%) had attention deficits than subjects receiving ethosuximide (32%) or lamotrigine (24%) (p 5 0.0006). Parental assessment did not reliably detect attention deficits before or after treatment (p , 0.0001). Conclusions:Children with CAE have a high rate of pretreatment attentional deficits that persist despite seizure freedom. Rates are disproportionately higher for valproic acid treatment compared with ethosuximide or lamotrigine. Parents do not recognize these attentional deficits. These deficits present a threat to academic achievement. Vigilant cognitive and behavioral assessment of these children is warranted.

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Section: Statistical Analysis Baseline Neurocognitive Test Results Amentioning

confidence: 99%

Pretreatment cognitive deficits and treatment effects on attention in childhood absence epilepsy

et al. 2013

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“…Because these syndromes have relatively poor prognosis compared with CAE [40], their inaccurate categorization as CAE may lead to misrepresentation of the prognosis for CAE in clinical studies. Several studies using ILAE criteria reported the remission rate of CAE to be 50-60% [40][41][42]. To overcome these issues, we used stricter criteria than the ILAE ones to diagnose CAE in this study.…”

Section: Initial-response Group (N = 12)mentioning

confidence: 92%

Temporal current-source of spikes suggests initial treatment failure in childhood absence epilepsy

Yeom

Kim

Lee

et al. 2015

Seizure

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“…Though believed to be rather an exception, pharmacoresistance in patients with IGE syndromes is an important issue, as up to 40% of patients with certain epilepsy syndromes like pGTCS on awakening, childhood or juvenile absence epilepsy or juvenile myoclonic epilepsy suffer from drug resistance [2][3][4][5][6][7]. Therapy strategies in these patients are based on the individual decision of the treating physician due to the lack of data on combination therapy.…”

Section: Expert Opinionmentioning

confidence: 98%

“…The term "idiopathic" was considered to be potentially misleading, as it could suggest a benign course of disease and particularly good treatment response [1]. Actually, though often considered "easy" to treat, up to 40% of patients with these epilepsy syndromes do not become seizure free with the first drug of choice and might also become pharmacoresistant [2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Perampanel for the treatment of primary generalized tonic-clonic seizures in idiopathic generalized epilepsy

Rohracher

Brigo

Höfler

et al. 2016

Expert Opinion on Pharmacotherapy

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A placebo-controlled clinical phase III study including 164 patients (≥ 12 years) with pGTCS in idiopathic generalized epilepsies (IGE) demonstrated efficacy of PER in reducing pGTCS with good tolerability profile, and without aggravating absence seizures or myoclonic seizures. Dizziness, the main adverse event (AE), can be avoided by bedtime administration. Psychiatric AEs ranging from mild depression to aggression and suicidal attempts should be especially monitored in patients with a history of psychiatric disorders. Co-administration of enzyme inducing antiepileptic drugs (AEDs) might decrease PER plasma levels and make dose adjustment necessary. A reduced efficacy of progesterone-containing oral contraceptives should be considered when administering PER to young women. There is lack of evidence on PER treatment in pregnancy. Although no teratogenic effects were observed in animal models, PER is not recommended for women of childbearing age without contraception.

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Long-term prognosis for childhood and juvenile absence epilepsy

Cited by 114 publications

References 23 publications

Pretreatment cognitive deficits and treatment effects on attention in childhood absence epilepsy

Pretreatment cognitive deficits and treatment effects on attention in childhood absence epilepsy

Temporal current-source of spikes suggests initial treatment failure in childhood absence epilepsy

Perampanel for the treatment of primary generalized tonic-clonic seizures in idiopathic generalized epilepsy

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