Clinical and EEG factors associated with antiseizure medication resistance in idiopathic generalized epilepsy.
case-control study
catamenial
epidemiology
outcome
prognosis
Journal
Epilepsia
ISSN: 1528-1167
Titre abrégé: Epilepsia
Pays: United States
ID NLM: 2983306R
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
revised:
18
09
2021
received:
11
08
2021
accepted:
08
10
2021
pubmed:
28
10
2021
medline:
21
4
2022
entrez:
27
10
2021
Statut:
ppublish
Résumé
We sought to determine which combination of clinical and electroencephalography (EEG) characteristics differentiate between an antiseizure medication (ASM)-resistant vs ASM-responsive outcome for patients with idiopathic generalized epilepsy (IGE). This was a case-control study of ASM-resistant cases and ASM-responsive controls with IGE treated at five epilepsy centers in the United States and Australia between 2002 and 2018. We recorded clinical characteristics and findings from the first available EEG study for each patient. We then compared characteristics of cases vs controls using multivariable logistic regression to develop a predictive model of ASM-resistant IGE. We identified 118 ASM-resistant cases and 114 ASM-responsive controls with IGE. First, we confirmed our recent finding that catamenial epilepsy is associated with ASM-resistant IGE (odds ratio [OR] 3.53, 95% confidence interval [CI] 1.32-10.41, for all study subjects) after covariate adjustment. Other independent factors seen with ASM resistance include certain seizure-type combinations (absence, myoclonic, and generalized tonic-clonic seizures [OR 7.06, 95% CI 2.55-20.96]; absence and generalized tonic-clonic seizures [OR 4.45, 95% CI 1.84-11.34]), as well as EEG markers of increased generalized spike-wave discharges (GSWs) in sleep (OR 3.43, 95% CI 1.12-11.36 for frequent and OR 7.21, 95% CI 1.50-54.07 for abundant discharges in sleep) and the presence of generalized polyspike trains (GPTs; OR 5.49, 95% CI 1.27-38.69). The discriminative ability of our final multivariable model, as measured by area under the receiver-operating characteristic curve, was 0.80. Multiple clinical and EEG characteristics independently predict ASM resistance in IGE. To improve understanding of a patient's prognosis, clinicians could consider asking about specific seizure-type combinations and track whether they experience catamenial epilepsy. Obtaining prolonged EEG studies to record the burden of GSWs in sleep and assessing for the presence of GPTs may provide additional predictive value.
Substances chimiques
Immunoglobulin E
37341-29-0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
150-161Informations de copyright
© 2021 International League Against Epilepsy.
Références
Jallon P, Latour P. Epidemiology of idiopathic generalized epilepsies. Epilepsia. 2005;46(Suppl 9):10-4.
Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, et al. ILAE classification of the epilepsies: position paper of the ILAE commission for classification and terminology. Epilepsia. 2017;58:512-21.
Szaflarski JP, Lindsell CJ, Zakaria T, Banks C, Privitera MD. Seizure control in patients with idiopathic generalized epilepsies: EEG determinants of medication response. Epilepsy Behav. 2010;17:525-30.
Mohanraj R, Brodie MJ. Outcomes of newly diagnosed idiopathic generalized epilepsy syndromes in a non-pediatric setting. Acta Neurol Scand. 2007;115:204-8.
Seneviratne U, Cook M, D'Souza W. The prognosis of idiopathic generalized epilepsy. Epilepsia. 2012;53:2079-90.
Kharazmi E, Peltola M, Fallah M, Keränen T, Peltola J. Idiopathic generalized epilepsies: a follow-up study in a single-center. Acta Neurol Scand. 2010; 122: 196-201.
Stevelink R, Koeleman BPC, Sander JW, Jansen FE, Braun KPJ. Refractory juvenile myoclonic epilepsy: a meta-analysis of prevalence and risk factors. Eur J Neurol. 2019;26:856-64.
Wirrell EC, Camfield CS, Camfield PR, Gordon KE, Dooley JM. Long-term prognosis of typical childhood absence epilepsy: remission or progression to juvenile myoclonic epilepsy. Neurology. 1996;47:912-8.
Nicolson A, Appleton RE, Chadwick DW, Smith DF. The relationship between treatment with valproate, lamotrigine, and topiramate and the prognosis of the idiopathic generalised epilepsies. J Neurol Neurosurg Psychiatry. 2004;75:75-9.
Choi H, Detyniecki K, Bazil C, Thornton S, Crosta P, Tolba H, et al. Development and validation of a predictive model of drug-resistant genetic generalized epilepsy. Neurology. 2020;13(95):e2150-60.
Seneviratne U, Boston RC, Cook M, D'Souza W. EEG correlates of seizure freedom in genetic generalized epilepsies. Neurol Clin Pract. 2017;7:35-44.
Sun Y, Seneviratne U, Perucca P, Chen Z, Tan MK, O'Brien TJ, et al. Generalized polyspike train. Neurology. 2018;6(91):e1822-30.
Kwan P, Arzimanoglou A, Berg AT, Brodie MJ, Allen Hauser W, Mathern G, et al. Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. 2010; 51:1069-77.
Schomer DL, Lopes da Silva F. Niedermeyer's Electroencephalography: Basic Principles, Clinical Applications, and Related Fields. Philadelphia: Wolters Kluwer Health, 2010.
Misulis K, Misulis KE. Atlas of EEG, Seizure Semiology, and Management. Oxford: Oxford University Press, Incorporated, 2013.
Hirsch LJ, LaRoche SM, Gaspard N, Gerard E, Svoronos A, Herman ST, et al. American clinical neurophysiology society's standardized critical care EEG terminology: 2012 version. J Clin Neurophysiol. 2013;30:1-27.
Hirsch LJ, Fong MWK, Leitinger M, LaRoche SM, Beniczky S, Abend NS, et al. American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology: 2021 Version. J Clin Neurophysiol. 2021;1(38):1-29.
Tabaeizadeh M, Aboul Nour H, Shoukat M, Sun H, Jin J, Javed F, et al. Burden of epileptiform activity predicts discharge neurologic outcomes in severe acute ischemic stroke. Neurocritical Care. 2020;32:697-706.
Westhall E, Rosén I, Rossetti AO, van Rootselaar AF, Wesenberg Kjaer T, Friberg H, et al. Interrater variability of EEG interpretation in comatose cardiac arrest patients. Clin Neurophysiol. 2015;126:2397-404.
Zweig MH, Campbell G. Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem. 1993;39:561-77.
Steyerberg EW, Vickers AJ, Cook NR, Gerds T, Gonen M, Obuchowski N, et al. Assessing the performance of prediction models. Epidemiology. 2010;21(1):128-38.
DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44(3):837-45.
Herzog AG, Fowler KM, Smithson SD, Kalayjian LA, Heck CN, Sperling MR, et al. Progesterone vs placebo therapy for women with epilepsy: A randomized clinical trial. Neurology. 2012;78:1959-66.
Meador KJ, Pennell PB, May RC, Gerard E, Kalayjian L, Velez-Ruiz N, et al. Changes in antiepileptic drug-prescribing patterns in pregnant women with epilepsy. Epilepsy Behav. 2018;84:10-4.
Cerulli Irelli E, Morano A, Cocchi E, Casciato S, Fanella M, Albini M, et al. Doing without valproate in women of childbearing potential with idiopathic generalized epilepsy: Implications on seizure outcome. Epilepsia. 2020;61:107-14.
Gesche J, Khanevski M, Solberg C, Beier CP. Resistance to valproic acid as predictor of treatment resistance in genetic generalized epilepsies. Epilepsia. 2017;58:e64-9.
Marson A, Burnside G, Appleton R, Smith D, Leach JP, Sills G, et al. The SANAD II study of the effectiveness and cost-effectiveness of valproate versus levetiracetam for newly diagnosed generalised and unclassifiable epilepsy: an open-label, non-inferiority, multicentre, phase 4, randomised controlled trial. Lancet. 2021;10(397):1375-86.
Glauser TA, Cnaan A, Shinnar S, Hirtz DG, Dlugos D, Masur D, et al. Ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy. N Engl J Med. 2010;4(362):790-9.
VanderWeele TJ, Ding P. Sensitivity analysis in observational research: introducing the E-value. Ann Intern Med. 2017;15(167):268-74.
Haneuse S, VanderWeele TJ, Arterburn D. Using the e-value to assess the potential effect of unmeasured confounding in observational studies. JAMA. 2019;12(321):602-3.
Gelisse P, Genton P, Thomas P, Rey M, Samuelian JC, Dravet C. Clinical factors of drug resistance in juvenile myoclonic epilepsy. J Neurol Neurosurg Psychiatry. 2001;70:240-3.
Matsuoka H. The seizure prognosis of juvenile myoclonic epilepsy. Jpn J Psychiatry Neurol. 1992;46:293-6.
Bartolomei F, Roger J, Bureau M, Genton P, Dravet C, Viallat D, et al. Prognostic factors for childhood and juvenile absence epilepsies. Eur Neurol. 1997;37:169-75.
Bouma PA, Westendorp RG, van Dijk JG, Peters AC, Brouwer OF. The outcome of absence epilepsy. Neurology. 1996;47:802-8.
Martínez-Juárez IE, Alonso ME, Medina MT, Durón RM, Bailey JN, López-Ruiz M, et al. Juvenile myoclonic epilepsy subsyndromes: family studies and long-term follow-up. Brain. 2006;129:1269-80.
Trinka E, Baumgartner S, Unterberger I, Unterrainer J, Luef G, Haberlandt E, et al. Long-term prognosis for childhood and juvenile absence epilepsy. J Neurol. 2004;251:1235-41.
Clarke S, Karoly PJ, Nurse E, Seneviratne U, Taylor J, Knight-Sadler R, et al. Computer-assisted EEG diagnostic review for idiopathic generalized epilepsy. Epilepsy Behav. 2019;29:106556.
Jensen CD, Gesche J, Krøigård T, Beier CP. Prognostic value of generalized polyspike trains and prolonged epileptiform EEG runs. J Clin Neurophysiol. 2019;38(3):208-12.
Conrad EC, Chugh N, Ganguly TM, Gugger JJ, Tizazu EF, Shinohara RT, et al. Using generalized polyspike train to predict drug-resistant idiopathic generalized epilepsy. J Clin Neurophysiol. 2020. Online ahead of print.
Szaflarski JP, Kay B, Gotman J, Privitera MD, Holland SK. The relationship between the localization of the generalized spike and wave discharge generators and the response to valproate. Epilepsia. 2013;54(3):471-80.
Huang Y, Pepe MS. Assessing risk prediction models in case-control studies using semiparametric and nonparametric methods. Stat Med. 2010;15(29):1391-410.
Gomez-Ibañez A, McLachlan RS, Mirsattari SM, Diosy DC, Burneo JG. Prognostic factors in patients with refractory idiopathic generalized epilepsy. Epilepsy Res. 2017;130:69-73.
Patel AD, Baca C, Franklin G, Herman ST, Hughes I, Meunier L, et al. Quality improvement in neurology: Epilepsy Quality Measurement Set 2017 update. Neurology. 2018;30(91):829-36.
Schrager SB. Five ways to communicate risks so that patients understand fam. Pract Manag. 2018;25:28-31.
Epstein RM, Alper BS, Quill TE. Communicating evidence for participatory decision making. JAMA. 2004;291(19):2359-66.
Prinjha S, Chapple A, Herxheimer A, McPherson A. Many people with epilepsy want to know more: a qualitative study. Fam Pract. 2005;22:435-41.