Authors :
Presenting Author: Shruti Agashe, MD, MS-BME – Duke University
bassel abou-khalil, MD – Vanderbilt University; Sarah Barnard, NA – Monash; Gregory Cascino, MD – Mayo Clinic Rochester; Kamil Detyniecki, MD – University of Miami; Orrin Devinsky, MD – NYU Langone; Jonah Fox, MD – University of Vanderbilt; Jacqueline French, MD – NYU Langone; Barry Gidal, MD – University of Wisconsin; Sheryl Haut, MD – Montefiore Enstein; Manu Hegde, MD – UCSF; John Hixson, MD – UCSF; Smitha Holla, MD – UW Madison; Manisha Holmes, MD – WMC Health; Reeta Kalvianinen, MD – Kuopio Epilepsy Center
Rationale:
In patients with focal epilepsy, focal to bilateral tonic clonic seizures (FBTCS) are associated with an increased risk of morbidity and mortality. It is unknown what predisposes some focal epilepsy patients to having FBTCS. Here, we studied the factors related to FBTCS in newly treated focal epilepsy.
Methods:
The data was derived from the Human Epilepsy Project study. Four hundred ninety-three newly diagnosed adults and adolescents with focal epilepsy were enrolled within four months of starting treatment and followed for three to six years. Data were abstracted from case report forms for baseline characteristics. The presence and frequency of all seizures following treatment were collected from prospective seizure diaries and medical records. The Kruskal Wallis test was used for non-parametric continuous variables and the Pearson Chi square test was used for categorical variables.
Results:
Four hundred forty seven subjects with newly diagnosed focal epilepsy were included in this study. Of these, 344 (77%) had FBTCS either pre or post treatment while 103 (23%) had exclusively FAS or FIAS. There were no differences in sex, age, family history, etiologies (e.g., trauma, stroke, hypoxic-ischemic encephalopathy, malformations of cortical development), repeating a grade, or requiring special accommodation between the two groups. Patients with mesial temporal sclerosis were slightly less likely to have FBTCS (p< 0.015). Too few patients had other etiologies (e.g., neurocutaneous, infections, neoplasia, dementia) for comparison.