High rates of early remission pattern in adult-onset compared with earlier-onset idiopathic generalized epilepsy: A long-term follow-up study.

Antiseizure medication (ASM) withdrawal Idiopathic generalized epilepsy (IGE) Late-onset Long-term seizure outcome prognostic factors prognostic patterns

Journal

Seizure
ISSN: 1532-2688
Titre abrégé: Seizure
Pays: England
ID NLM: 9306979

Informations de publication

Date de publication:
Jan 2022
Historique:
received: 04 06 2021
revised: 15 11 2021
accepted: 16 11 2021
pubmed: 6 12 2021
medline: 30 12 2021
entrez: 5 12 2021
Statut: ppublish

Résumé

To investigate electroclinical characteristics and prognostic patterns of adult-onset vs. younger-onset idiopathic generalized epilepsy (IGE) patients during long-term follow-up. In this single-center retrospective cohort comparative study, adult-onset IGE was defined as onset after 20 years of age. Patients with a follow-up duration between 10 and 30 years from epilepsy diagnosis were enrolled. Maximum follow-up duration was limited to 30 years to ensure a better comparison of prognostic data between adult-onset and younger-onset patients. The Benjamini-Hochberg false discovery rate (FDR) method was applied to obtain FDR-adjusted p-values. A total of 177 IGE patients were recruited and 27 adult-onset IGE patients were identified (15.3%). Follow-up duration was similar between younger- and adult-onset IGE patients and 74% of subjects performed at least one 24-hour EEG recording. Of adult-onset IGE patients, 8/27 were diagnosed with juvenile myoclonic epilepsy, while 19/27 were diagnosed with generalized tonic-clonic seizures (GTCS) only. EEG photosensitivity and absence seizures were significantly less frequent among adult-onset IGE patients as compared with younger subjects. When considering prognostic patterns, an early remission pattern was significantly higher among adult-onset IGE patients as compared with younger-onset IGE patients (55.6% vs. 24%, adjusted p value = 0.007). Antiseizure medication withdrawal was attempted in 3/27 adult-onset patients, and all had GTCS relapses. Our study contributes to better defining the electroclinical characteristics and long-term follow-up of adult-onset IGE patients. A favorable long-term seizure outcome was found in adult-onset IGE patients, as evidenced by the high rates of early remission pattern when compared with younger onset patients.

Identifiants

pubmed: 34864252
pii: S1059-1311(21)00378-2
doi: 10.1016/j.seizure.2021.11.019
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

52-56

Informations de copyright

Copyright © 2021 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Auteurs

Emanuele Cerulli Irelli (E)

Epilepsy Unit, Department of Human Neurosciences, Policlinico "Umberto I", "Sapienza" University, Rome, Italy.

Biagio Orlando (B)

Epilepsy Unit, Department of Human Neurosciences, Policlinico "Umberto I", "Sapienza" University, Rome, Italy.

Enrico M Salamone (EM)

Epilepsy Unit, Department of Human Neurosciences, Policlinico "Umberto I", "Sapienza" University, Rome, Italy.

Giacomo Fisco (G)

Epilepsy Unit, Department of Human Neurosciences, Policlinico "Umberto I", "Sapienza" University, Rome, Italy.

Francesca A Barone (FA)

Epilepsy Unit, Department of Human Neurosciences, Policlinico "Umberto I", "Sapienza" University, Rome, Italy.

Alessandra Morano (A)

Epilepsy Unit, Department of Human Neurosciences, Policlinico "Umberto I", "Sapienza" University, Rome, Italy.

Martina Fanella (M)

Epilepsy Unit, Department of Human Neurosciences, Policlinico "Umberto I", "Sapienza" University, Rome, Italy.

Jinane Fattouch (J)

Epilepsy Unit, Department of Human Neurosciences, Policlinico "Umberto I", "Sapienza" University, Rome, Italy.

Mario Manfredi (M)

Epilepsy Unit, Department of Human Neurosciences, Policlinico "Umberto I", "Sapienza" University, Rome, Italy.

Anna T Giallonardo (AT)

Epilepsy Unit, Department of Human Neurosciences, Policlinico "Umberto I", "Sapienza" University, Rome, Italy.

Carlo Di Bonaventura (C)

Epilepsy Unit, Department of Human Neurosciences, Policlinico "Umberto I", "Sapienza" University, Rome, Italy. Electronic address: c_dibonaventura@yahoo.it.

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Classifications MeSH