Journal
JOURNAL OF CHILD NEUROLOGY
Volume 25, Issue 4, Pages 475-481Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/0883073809341665
Keywords
childhood absence epilepsy; prognosis; generalized tonic-clonic seizures; antiepileptic drugs
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Funding
- National Institutes of Health [NS37466, NS27941, NSO47530, DK31775]
- Partnership for Pediatric Epilepsy Research
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [R01DK031775] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE [R01NS047530, R01NS027941, R01NS037466] Funding Source: NIH RePORTER
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About 40% of children with childhood absence epilepsy develop generalized tonic-clonic seizures. It is commonly held that polyspike wave pattern on the electroencephalogram (EEG) can predict this development of generalized tonic-clonic seizures. However, there is no firm evidence in support of this proposition. To test this assumption, we used survival analysis and compared the incidence of generalized tonic-clonic seizures in 115 patients with childhood absence epilepsy having either isolated 3-Hz spike wave or coexisting 3 Hz and polyspike waves and other variables. There was no evidence that polyspike waves predicted development of generalized tonic-clonic seizures in patients with childhood absence epilepsy. Later age of onset (>= 8 years) and family histories of generalized tonic-clonic seizures were the only independent predictors. These results have implications for counseling and in the choice of first-line antiepileptic drugs used for childhood absence epilepsy, especially if valproate is chosen based on the observation of polyspike waves.
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