Clinical Characteristics and EEG Findings of Patients with Childhood Absence Epilepsy
Öz
Abstract
Aim
This study aimed to describe the clinical features and electroencephalographic (EEG) findings of patients with childhood absence epilepsy (CAE) and to evaluate the relationship of these parameters with treatment response.
Methods
Twenty-one patients diagnosed with childhood absence epilepsy (CAE) between 2021 and 2024 were included in the study. Demographic data, seizure characteristics, timing of treatment initiation, clinical examination findings, baseline EEG recordings, and treatment responses during follow-up were retrospectively analyzed. Pre-treatment EEG recordings were re-evaluated by a pediatric neurologist.
Results
Twenty-one patients were included. The mean age at seizure onset was 7.3 years (range: 4.5 to 11 years). The gender distribution was almost equal: 47.6% girls and 52.4% boys. Approximately one-third of the patients had accompanying motor components. During the hyperventilation test, seizures were observed in 15 cases (71.4%) and spike-wave discharges in EEG were seen in 18 (85.7%). Epileptic discharges were detected in four cases (19%) during intermittent photic stimulation. The duration of discharges in EEG was most frequently in the range of 1-10 seconds. Focal fragments were detected in six patients (28%), and OIRDA in five ( 23%). Complete treatment response was achieved in 90.9% of patients with ≤4 discharges frequency and in 70% of those with >4 discharge frequency. All patients initially treated with ethosuximide achieved complete seizure control, whereas response rates were lower in the valproate and lamotrigine groups. Patients who started treatment within three months had higher response rates. No seizures were observed in subsequent follow-ups of patients who achieved early complete response.
Conclusion
Combined evaluation of clinical and EEG findings in CAE is crucial for treatment planning and prognosis estimation. Although focal findings do not always indicate a poor outcome, they should be interpreted with caution.
Anahtar Kelimeler
Idiopathic generalized epilepsy, Childhood Absence Epilepsy, Absence seizures, Electroclinical features, Therapeutic outcomes.
Destekleyen Kurum
This research did not receive any specific grant from funding agencies in the public, commercial, or not-forprofit sectors.
Etik Beyan
This study was initiated after receiving approval from the Ethics Committee of Gülhane Training and Research Hospital (Decision No: 2025/30, Date: 06.02.2025).
Teşekkür
The authors wish to thank the patients and families who participated in this study.
Kaynakça
- 1. Hirsch E, French JA, Scheffer IE, Bogacz A, Alsaadi T, Sperling MR, et al. ILAE definition of the idiopathic generalized epilepsy syndromes: Position statement by the ILAE Task Force on Nosology and Definitions. Epilepsia. 2022;63(6):1475–1499
- 2. Olsson I, Hedström A. Epidemiology of absence epilepsy. II. Typical absences in children with encephalopathies. Acta Paediatr Scand. 1991;80(2):235-42
- 3. Loiseau J, Loiseau P, Guyot M, Duche B, Dartigues JF, Aublet B. Survey of seizure disorders in the French southwest. I. Incidence of epileptic syndromes. Epilepsia. 1990;31(4):391-6
- 4. Kessler SK, Shinnar S, Cnaan A, Dlugos D, Conry J, Hirtz DG. et al. Childhood Absence Epilepsy Study Group. Pretreatment seizure semiology in childhood absence epilepsy. Neurology. 2017;89(7):673-679
- 5. Pearl PL. Epilepsy Syndromes in Childhood. Continuum (Minneap Minn). 2018;24(1, Child Neurology):186-209
- 6. Akyuz E, Ozenen C, Pinyazhko OR, Poshyvak OB, Godlevsky LS. Cerebellar contribution to absence epilepsy. Neurosci Lett. 2021;761:136110
- 7. Matricardi S, Verrotti A, Chiarelli F, Cerminara C, Curatolo P. Current advances in childhood absence epilepsy. Pediatr Neurol. 2014;50(3):205-12
- 8. Callenbach PM, Bouma PA, Geerts AT, Arts WF, Stroink H, Peeters EA. et al. Long-term outcome of childhood absence epilepsy: Dutch Study of Epilepsy in Childhood. Epilepsy Res. 2009;83(2-3):249-56
- 9. Shinnar S, Cnaan A, Hu F, Clark P, Dlugos D, Hirtz DG, et al. Childhood Absence Epilepsy Study Group. Long-term outcomes of generalized tonic-clonic seizures in a childhood absence epilepsy trial. Neurology. 2015;85(13):1108-14
- 10. Rozenblat T, Kraus D, Mahajnah M, Goldberg-Stern H, Watemberg N. Absence seizure provocation during routine EEG: Does position of the child during hyperventilation affect the diagnostic yield? Seizure. 2020;79:86-89