Electro-Clinical Features of Adult Patients with Epilepsy and Down Syndrome. A Single Center Experience
Abstract number :
3.188
Submission category :
4. Clinical Epilepsy / 4A. Classification and Syndromes
Year :
2021
Submission ID :
1826026
Source :
www.aesnet.org
Presentation date :
12/9/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:51 AM
Authors :
Joaquín Ojeda, MD - Hospital U. Infanta Sofía; Susana López – Atención Primaria. Madrid; Francisco Navacerrada – Neurology – Hospital U. Infanta Sofía; Maria Jose Abenza – Neurology – Hospital U. Infanta Sofía
Rationale: Epilepsy is a frequent condition in patients with Down Syndrome (DS). Most descriptive studies in this patient population are performed in pediatric and adolescent patients, and very few in adult populations.
Methods: We retrospectively studied the clinical and neurophysiological features of consecutively adult patients ( >18 yo) diagnosed with DS and epilepsy in a epilepsy clinic of a secondary hospital (2010-2020).
Results: 9 patients were included. Mean age 35.7 yo (SD: 16). Males: 3/9. Years since epilepsy diagnosis: 19. Reason for consultation: Poor seizure control: 5/9. Diagnosis confirmation: 4/9.
Epilepsy type. Focal epilepsy: 6. Generalized epilepsy: 1. Non-epileptic paroxysmal events: 2
Etiology of DS patients with epilepsy 7/9). Cryptogenic epilepsy 7/7. No MRI patological findings in 7/7
History of infantile spasms: 2/7. Atypical febrile seizures: 2/7.
Comorbidities: 2/9 structural heart disease. 3/9 psychiatric comorbidity (anxiety).
Onset of epilepsy. In the first year of life: 3/7. 1-12a: 2/7. > 12a: 2/7.
Degree of social/work integration: Special center: 2/9. Company: 2/9. Non-work inclusion: 5/9. Dwelling place: Institutionalization 7d / 24h: 3/9. Occupational center: 3/9. Family house: 6/9. Protected flat: 1/9.
Seizure semiology. Complex focal: 6/7. Secondary generalized: 2/7. Generalized tonic-clonic: 1/7. Management: Optimal control with monotherapy (both VPA): 2/7. Drug-resistant epilepsy: 5/7. Dual therapy: 3/7. Triple therapy: 2/7. Mean AEDs used: 7 (SD: 4). 1 patient died (generalized convulsive status epilepticus).
Neurophysiology. Intercritical EEG Pattern: 7/7. Epileptiform abnormalities: 6/7. Focal spike/wave: 6/7. Generalized spikes: 1/7. Focal slowing: 6/7. Generalized slowing: 1/7. Patients with non-epileptic (NE) events: 2/9 (VideoEEG confirmed). Both NE performed the highest social/occupational integration of the sample.
Conclusions: Epilepsy in patients with Down Syndrome is a diagnostic challenge, due to the high prevalence of non-epileptic events. Etiology is mainly cryptogenic. Epilepsy in these patients is often drug resistant. Epileptiform abnormalities is a common finding in DS patients with epilepsy.
Funding: Please list any funding that was received in support of this abstract.: No funding.
Clinical Epilepsy