Typical absence seizures and their treatment

Panayiotopoulos, C. P.

doi:10.1136/adc.81.4.351

Cited by 109 publications

(92 citation statements)

References 14 publications

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“…In 14 patients (70%) in this series, an increase was found in the frequency of epileptic seizures that was attributed to the use of antiepileptic drugs that are contraindicated for patients with absence seizures, thereby confirming the importance of the new ILAE classification 19 , which now includes selective response to antiepileptic drugs as part of the classification criteria 2,[20][21][22] . Incorrect diagnosis based on the presence of apparently focal characteristics 23,24 , as well as interictal EEG scans with focal abnormalities 7 , were also found in our patients and were confounding factors in the differential diagnosis with focal epilepsy.…”

Section: Discussionsupporting

confidence: 64%

“…Absence seizures (AS) are classified under the category of generalized epilepsies; however, unlike other seizures, absence seizures possess clinical characteristics and electroencephalographic (EEG) patterns that are specific for this diagnosis [1][2][3] and occur in different epileptic syndromes. Absence seizures may be divided into typical absences and atypical absences, according to EEG pattern.…”

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confidence: 99%

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Clinical and electroencephalographic characteristics of a cohort of patients with epilepsy and absence seizures

Alves-Leon

Cardoso

Pereira³

et al. 2009

Arq. Neuro-Psiquiatr.

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-Background: Epileptic syndromes with absence seizures (AS) possess unique clinical and electroencephalographic (EEG) characteristics. In typical or atypical AS, ictal phenomenology may include various characteristics. Vídeo-EEG monitoring enables findings to be correlated with ictal phenomenology. Objective: To evaluate the different AS in a cohort of patients with drug-resistant epilepsy (DRE) based on the International League against Epilepsy (ILAE)'s 2006 classification, to correlate with ictal phenomenology recorded and to apply the Panayiotopoulos criteria. Method: This study included patients with criteria of AS followed up at the Epilepsy Clinic. A dual, cross-sectional cohort study was carried out between 2005 and 2008. Patients receiving care in the Epilepsy Program of the HUCFF-UFRJ, who had been investigated by video-EEG and who presented clinical and EEG criteria for absence seizures, typical or atypical, according to the criteria defined by the ILAE, were included in the study, independent of age onset, the review of clinical history, age onset, family history, epilepsy onset and evolution, seizures phenomenology, antiepileptic drugs response and neuroimaging studies were used to classify the patients among the different epileptic syndrome associated to absence seizures. Results: Typical absences were more frequent (71.4%) than atypical absences. Cases of juvenile absence epilepsy were the most frequent (19%) in this series, followed by childhood absence epilepsy (14.4%) and juvenile myoclonic epilepsy (4.8%). In 14 patients (66.67%), diagnosis was modified from focal epilepsy to primary generalized epilepsy. Clinical and EEG diagnosis of absence epilepsy resulted in a dramatic improvement in the control of seizures following modification of diagnosis and indication of an appropriate antiepileptic drug. Conclusion: Our results show that typical AS are more frequent than atypical. AS was successfully defined in 10 patients following application of Panayiotopoulos' criteria. The consequent change in diagnosis and therapy resulted in resolution of refractoriness in 9 patients. We concluded that in DRE, AS associated to unusual ictal phenomenology improve dramatically when diagnosed by video-EEG, permitting seizures to be controlled. Clinical and EEG evaluation confirm that myoclonus, automatisms and autonomic disorders are involved and that the consciousness may be affected to different degrees.

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Section: Discussionsupporting

confidence: 64%

mentioning

confidence: 99%

Clinical and electroencephalographic characteristics of a cohort of patients with epilepsy and absence seizures

Alves-Leon

Cardoso

Pereira³

et al. 2009

Arq. Neuro-Psiquiatr.

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“…During an absence, ongoing activity is halted and a person's responsiveness is usually briefly impaired (Panayiotopoulos, 1999). Furthermore, typical absence epileptic seizures are electrophysiologically characterized by a pattern of bilateral synchronized spike wave discharges (SWDs) (Blumenfeld et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

The anti-absence effect of mGlu5 receptor amplification with VU0360172 is maintained during and after antiepileptogenesis

D'Amore

Raaijmakers

Santolini

et al. 2016

Pharmacology Biochemistry and Behavior

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Ethosuximide (ETX) has become the drug of choice in the treatment of patients with absence seizures taking into account both its efficacy, tolerability and antiepileptogenic properties. However, 47% of subjects treated with ETX failed in therapy, and most antiepileptic drugs have cognitive side effects. VU0360172, a positive allosteric modulator (PAM) of mGluR5, acutely and chronically administered decreased seizures dose dependently in rats of the WAG/Rij strain, a genetic absence model. Here it is investigated whether anti-epileptogenesis induced by ETX alters the sensitivity of VU0360172 as an anti-absence drug, and cognition is affected during and after chronic ETX treatment.Method: Male WAG/Rij rats were chronically treated with ETX for 4 months. EEG's were recorded during and after treatment as well as challenged with VU0360172. Rats were also periodically exposed to a cue discrimination learning task in a Y-maze. mGlu5 receptors were quantified with Western Blot.Results: Antiepileptogenesis was successfully induced by ETX and VU0360172 showed a time and dose dependent anti-absence action. However, chronic ETX treated rats showed a decrease in absences both during and after the end treatment, without clear time and dose related effects. The decrease of sensitivity for VU0360172 was not accompanied by a change in mGluR5 expression in cortex and thalamus. Chronic ETX enhanced motivation to collect sucrose pallets and this was followed by an increase in cued discrimination learning.It is concluded that VU0360172 keeps its antiabsence effects after chronic treatment. Moreover, its differential effects in the two groups cannot be explained by a simple receptor down regulation suggesting a more downstream interaction between ETX and mGluR5. The cognitive enhancing effects of ETX, as found at the end of the experiment might be mediated to the antidepressant action of ETX as expressed by an increase in the rewarding properties of sucrose pallets.

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“…The occurrence of sleep spindles in the EEG is associated with loss of perceptual awareness and it is remarkable that this 'low vigilance' state is also favorable for the occurrence of absence epilepsy (e.g., a non-convulsive generalized epilepsy of unknown etiology). Typical absence seizures are characterized by bilaterally symmetric 3-5 Hz spike-waves complexes in the EEG (Panayiotopoulos, 1999). Some inbred rat strains, such as Genetic Absence Epilepsy Rats from Strasbourg (GAERS, Marescaux et al, 1992) and Wistar Albino Glaxo from Rijswijk (WAG/Rij, van Luijtelaar and Coenen, 1986), have a genetic predisposition to absence epilepsy and exhibit spontaneously occurring spike-wave seizure activity in their EEG concurrently with mild clinical concomitants (Coenen and van Luijtelaar, 2003).…”

Section: Introductionmentioning

confidence: 99%

Sleep spindles and spike–wave discharges in EEG: Their generic features, similarities and distinctions disclosed with Fourier transform and continuous wavelet analysis

Sitnikova

Hramov

Koronovsky

et al. 2009

Journal of Neuroscience Methods

136

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Typical absence seizures and their treatment

Cited by 109 publications

References 14 publications

Clinical and electroencephalographic characteristics of a cohort of patients with epilepsy and absence seizures

Clinical and electroencephalographic characteristics of a cohort of patients with epilepsy and absence seizures

The anti-absence effect of mGlu5 receptor amplification with VU0360172 is maintained during and after antiepileptogenesis

Sleep spindles and spike–wave discharges in EEG: Their generic features, similarities and distinctions disclosed with Fourier transform and continuous wavelet analysis

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