Absence epilepsy: early prognostic signs

Seizure. 1992 Dec;1(4):281-9. doi: 10.1016/1059-1311(92)90038-3.

Abstract

We have studied 124 children with typical absence epilepsy. The onset of symptoms was in 12% under 4 years, in 51% between 4-8 years and in 37% above 8 years. The F:M ratio was 2:1 in children under 4 years versus 1:1 above 8 years. Absences alone occurred in 82% and absences followed or preceded by generalized tonic-clonic seizures (GTCS) in 6.5% and 11%, respectively. Simple absences were not seen in children under 4 years and were more frequent (14%) in the 4-8 years age group. Family history was positive for epilepsy in 20% and febrile convulsion in 7%. Sixteen percent had a positive past history of febrile convulsions. All patients showed bilateral, synchronous spike-wave discharges from 2.5 to 4 c/s. Lateralized spikes, spike-slow wave complexes were found in 27%. Photosensitivity was present in 18% and was marked in 12%. Monotherapy with sodium valproate or ethosuximide (91% SV) was successful in 85% of patients with absences alone and 68% of the absences with GTCS. Only 2% were not fully controlled either on monotherapy or polytherapy. Treatment was withdrawn in 41 patients and 13 relapsed. We have identified four factors associated with relapses: (a) poor initial response to treatment, (b) lateralized focal EEG abnormality and/or marked photosensitivity, (c) the evolution to myoclonic epilepsy, and (d) early withdrawal of AED (< 3 years).

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Drug Therapy, Combination
  • Educational Status
  • Electroencephalography / drug effects
  • Epilepsy, Absence / diagnosis*
  • Epilepsy, Absence / drug therapy
  • Epilepsy, Absence / genetics
  • Epilepsy, Tonic-Clonic / diagnosis*
  • Epilepsy, Tonic-Clonic / drug therapy
  • Epilepsy, Tonic-Clonic / genetics
  • Female
  • Humans
  • Male
  • Prognosis
  • Recurrence
  • Risk Factors
  • Seizures, Febrile / diagnosis
  • Seizures, Febrile / drug therapy
  • Seizures, Febrile / genetics