Abstracts

Rationale: To study the prevalence of epileptiform discharges (ED) in EEG and risk of seizures in 12-16 year old children of women with epilepsy (WWE) Methods: This study was carried at Kerala Registry of Epilepsy and Pregnancy(KREP) at Sree Chitra Tirunal Institute for Medical Sciences and Technology, a tertiary referral Neurological centre in South India. KREP is a unique program, enrolling WWE in preconception period or first trimester of pregnancy and prospectively following them up through pregnancy and delivery from 1998. Infants in this program are followed up prospectively according to a standard protocol. As per the protocol, all babies are clinically examined at birth, at three months of age (with echocardiogram and ultrasonogram for the presence of birth defects), at 1 yr, 6 yr and 12 years of age. The developmental outcome at one year, IQ and language function at six years are assessed. Children born to WWE and prospectively followed up at KREP from 1998- 2015, aged 12-16 yrs (n = 92) underwent clinical evaluation and 30 minute digital 18 channel EEG. 39 (42.4%) of them had EEG taken at 6 years of age available Results: 92 children aged between 12-16 years; born to 88 WWE underwent EEG recording. Maternal AED usage was Carbamazepine(37),Phenobarbitone(18),Valproate(29), Phenytoin(14),Clonazepam(5)and Primidone(4).There were 5 children without AED exposure in antenatal period; others were exposed to monotherapy(62) or polytherapy(25). Childhood antecedents were seen in 11 children. Foetal distress and birth asphyxia were seen in 4 children. 9 children had history of seizures; one had neonatal seizures, 7 had febrile seizures, and 2 had epilepsy. 5 out of the 48 males(38.5%) and 8 out of the 44 females(52.5%) had epileptiform abnormalities. This was in excess of what was expected in EEG of normal healthy children. Epileptiform abnormalities were seen in 13 children of which 9 had generalized discharges and 4 had focal epileptiform abnormalities. Of the four with focal epileptiform abnormalities, all were extratemporal ?"occipital(2),frontal(1) and centroparietal(1). Of the 39 children with EEG at 6 year of age, 5(12.8%) had epileptiform abnormalities; which was similar to the prevalence(14.1%) in our study in the 12-16 age group. Four of the epileptiform abnormalities were focal and extratemporal(2 frontal,1 occipital,1 centroparietal). One child had generalized epileptiform abnormality. Of the 2 children with epilepsy, one with localization related epilepsy and the other generalized epilepsy. On comparing with data available for normal children aged 10-19 years, the relative risk for developing epilepsy was 3.33 (CI 0.84-13.2 ). Of the 2 children who had epilepsy , only one had both EEG available; and the 6 year EEG did not reveal any epileptiform abnormalities in that child. The maternal epilepsy syndromes were generalized epilepsy in 44, localization related epilepsy in 46 and unspecified for 2 Conclusions: Children of WWE have higher risk of epileptiform activity in EEG and seizure risk compared to healthy children Funding: No