Electroclinical features and long-term therapeutic response in patients with typical absence seizures

Autor: Sándor Beniczky, Jakob Christensen, Marina Nikanorova, Natalya Nikanorova, Gija Rackauskaite, Maria Vlachou, Mustafa Aykut Kural, Georgios Alexandros Skrimpas
Rok vydání: 2021
Předmět:
Zdroj: Aarhus University
Vlachou, M, Skrimpas, G A, Kural, M A, Rackauskaite, G, Nikanorova, N, Christensen, J, Nikanorova, M & Beniczky, S 2022, ' Electroclinical features and long-term therapeutic response in patients with typical absence seizures ', European Epilepsy Congress, Geneva, Switzerland, 09/07/2022-13/07/2022 .
Vlachou, M, Skrimpas, G A, Kural, M A, Rackauskaite, G, Nikanorova, N, Christensen, J, Nikanorova, M & Beniczky, S 2021, ' Electroclinical features and long-term therapeutic response in patients with typical absence seizures ', 4th Annual Research Meeting, Aarhus, Denmark, 23/11/2021-23/11/2021 .
Vlachou, M, Skrimpas, G A, Kural, M A, Rackauskaite, G, Nikanorova, N, Christensen, J, Nikanorova, M & Beniczky, S 2022, ' Electroclinical features and long-term therapeutic response in patients with typical absence seizures ', Epileptic Disorders, vol. 24, no. 2, pp. 315-322 . https://doi.org/10.1684/epd.2021.1392
ISSN: 1950-6945
Popis: OBJECTIVE: To characterize in detail the electroclinical features of typical absence seizures and elucidate whether EEG or semiology features, alone or in combination, can predict long-term therapeutic outcome. METHODS: We analysed video-EEG recordings from 213 typical absence seizures from 61 patients with idiopathic generalized epilepsy. We extracted semiological features, in addition to hallmark manifestations (motor/behavioural arrest, non-responsiveness), their location, timing and frequency. We evaluated the duration and frequency of generalized spike-wave discharges and the presence of polyspikes. We used a supervised machine-learning approach (random forest) to search for classifier features for long-term therapeutic outcome (>one year). RESULTS: Besides the hallmark manifestations, additional semiological features were identified in 87% of patients (75% of seizures). The most common additional semiological features were automatisms and eye blinking (observed in 45% and 41.5% of seizures, respectively). Automatisms were associated with longer seizure duration, and oral automatisms occurred earlier compared to limb automatisms (4.03 vs. 6.19 seconds; p=0.005). The mean duration of the ictal spike-wave discharges was nine seconds, and the median frequency was 3 Hz. Polyspikes occurred in 46 seizures (21.6%), in 19 patients (31%). Median follow-up was five years, and 73% of the patients were seizure-free at the end of the follow-up. None of the semiological features, alone or in combination, were predictors of therapeutic outcome. The only significant classifier was the presence of polyspikes, predicting a non-seizure-free outcome with an accuracy of 73% (95% CI: 70-77%), positive predictive value of 92% (95% CI: 84-98%) and negative predictive value of 60% (95% CI: 39-81%). SIGNIFICANCE: Semiological features, in addition to behavioural arrest and non-responsiveness, are common in typical absence seizures, but they do not predict long-term therapeutic outcome. The presence of polyspikes has a high positive predictive value for unfavourable therapeutic outcome, and their presence should therefore be included when reporting EEGs in patients with typical absence seizures.
Databáze: OpenAIRE
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