Effects of the New ILAE-Diagnostic Criteria for Epilepsy - A Prospective Study
Abstract number :
V.034
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2021
Submission ID :
1826092
Source :
www.aesnet.org
Presentation date :
12/9/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:52 AM
Authors :
Lena Habermehl, MD, Dr. med. - Epilepsy Centre Hessen, Philipps-University Marburg; Louise Biermann - Epilepsy Centre Hessen, Philipps-University Marburg; Susanne Knake - Epilepsy Centre Hessen, Philipps-University Marburg
Rationale: In 2014, the ILAE proposed a new definition of epilepsy, which found entrance into the new guideline of the German Association of Neurology. Epilepsy can now be diagnosed and treated after a first unprovoked seizure if the recurrence risk is estimated to be higher than 60% over the course of 10 years. Consequences of the new definition are unpredictable.
Methods: A prospective analysis of patients who appear with a first epileptic seizure at University Hospital Marburg since February 2018 was performed. The present sample contains patients who completed up to one year of follow up (FU) assessments.
The statistical analyses included frequency and descriptive analyses to assess the relative frequencies of the various clinical features in the sample. Descriptive statistics are reported as absolute numbers with percentages, means (M) ± standard deviations (SD). Two binary logistic regressions were conducted with seizure freedom (yes/no) 6 and 12 months after the first epileptic seizure as dependent variable and age at first seizure, epileptiform discharges in EEG and epileptogenic lesions in MRI as predictors.
Results: 172 patients (41.9 % female) with clinically diagnosed first epileptic seizure were included. 64% meet the new diagnostic criteria for epilepsy. 36.4% of the patients with epilepsy (PWE) showed epileptiform discharges in EEG, 28.2% had epileptogenic lesions in MRI. 26.7% showed typical findings in both modalities. At first FU (6.08 months ± 1.36), 59.8% of the PWE were seizure free. At second FU (12.44 months ±1.81), 80.3% or the PWE were seizure free. Reasons for revision of the diagnoses were mostly misinterpretation of the MRI or acute symptomatic seizures.
Conclusions: In our cohort, 64% of the new diagnoses of epilepsy were made after one single seizure. That’s about twice as much as risk of recurrent seizures after a first and illustrates a high overdiagnosis. Obviously, the new definition for epilepsy requires clinical knowledge about acute symptomatic seizures and epileptogenic MRI-lesions in particular, to prevent severe overdiagnosis.
Funding: Please list any funding that was received in support of this abstract.: none.
Clinical Epilepsy