Abstracts

This prospective study was performed to classify absence seizures in childhood with respect to seizure semiology and epilepsy syndrome, and evaluate treatment and outcome., Patients were referred to our pediatric neurology clinic with a diagnosis of absence epilepsy based on clinical and/or EEG features. Initial evaluation included detailed history obtained from parents, physical and neurological examination, and routine EEG, followed by video-EEG monitoring, neuroimaging, and psychometric analysis. Patients were followed up at 1, 3, 6 and 12 months after initiation of antiepileptic drug (AED) treatment., 32 patients were studied. Age at initial symptom ranged between 10 months-15 years 5 months (mean: 8 years 9 months[plusmn]4 years 1 month). Age at the time of diagnosis ranged between 5 years 2 months-15 years 6 months. Neuroimaging studies were available in 30 patients, 29 patients had MRI (9 were abnormal) and one had CT. Psychometric analysis was available in 17 patients and showed normal IQ results; they did not show a significant difference at follow up. Video-EEG monitoring was available in 23 patients; a total of 202 ictal recordings were obtained. 25 patients had typical absence seizures (TAS); they were classified as childhood absence epilepsy (n:8), juvenile absence epilepsy (n:10), juvenile myoclonic epilepsy (n: 3), eyelid myoclonia with absences (n:2), perioral myoclonia with absences (n:1), diffuse epileptic EEG with eye closure (n:1). The remaining 7 patients without TAS were diagnosed with symptomatic/cryptogenic absence epilepsy (n: 6) and benign epilepsy with centrotemporal spikes (n:1). 27 patients were followed for 1-17 months (mean:7,8 months), 5 had shorter follow-up periods. One patient showed poor compliance and dropped out of study at 6 months. Otherwise all patients with TAS were reportedly seizure-free and showed EEG improvement. 19 patients were started on an AED for the first time, others received add on therapy. 53.1 % of the patients were on valproate , 34.4 % were on ethosuximide, 9.4 % were on lamotrigine, and 3.1 % were on clobazam., Clinical evaluation, including history, physical examination, and routine EEG along with neuroimaging studies, provide major clues in the diagnosis of absence epilepsy. However video-EEG monitoring with ictal recordings are essential for precise subclassification of patients with absence seizures. Correct classification of seizures and epilepsy syndromes are crucial in determining treatment plans and prognosis., (Supported by the Hacettepe University Research Fund (01 G 010, PI: Meral Topcu). D.Y. is supported by NIMH ICORTHA Fogarty International Center Mental Health and Developmental Disabilities Research Training Program (D43TW05807) at Children[apos]s Hospital Boston, PI: Kerim M. Munir.)