In a group of 96 children and teenagers suffering from absence epilepsy, we compared the efficacy of treatment with a valproic acid derivative, Depakin (D). In 72 patients of group 1, the EEGs contained typical bursts similar to absence seizure phenomena (generalized 3–4 Hz spike/wave complexes, SWCs). In 24 patients, these EEG phenomena were combined with other types of epileptiform elements (generalized and focal irregular peak/wave complexes, single and grouped sharp waves, spikes, polyspikes, etc.). It was found that pharmacotherapy with D effectively eliminated SWCs generated in the resting state of the patients; epileptiform phenomena provoked by hyperventilation and rhythmic photostimulation were noticeably more resistant from this aspect. The efficacy of treatment with D was considerably higher in group 1 (patients with the EEG patterns including only SWCs) than in group 2 (patients with deviating EEG patterns containing, together with SWCs, epileptiform elements of other types). Six months after the D therapy initiation, complete elimination of typical 3–4 Hz SWCs was observed in 63.9% of group-1 patients and in 41.7% of group-2 patients.
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References
A. T. Berg, S. F. Berkovic, M. J. Brodie, et al., “Revised terminology and concepts for organization of seizures and epilepsies: Report of the ILAE Commission on Classification and Terminology, 2005–2009”, Epilepsia, 51, No. 4, 676–685 (2010).
Electroencephalography: Basic Principles, Clinical Applications, and Related Fields, E. Niedermeyer, F. Lopes da Silva, eds., Lippincott Williams and Wilkins, Philadelphia (2005), pp. 684–687.
G. B. Ricci and R. Vizzioli, “Bilateral spike and wave complexes and cortical focus,” Electroencephalogr. Clin. Neurophysiol., 6, 534-35 (1964).
A. Gambardella, U. Aguglia, R. Guerrini R, et al., “Sequential occurrence of benign partial epilepsy and childhood absence epilepsy in three patients,” Brain Dev., 18, No. 3, 212-115 (1996).
B. Echenne, F. Rivier, A. Roubertie, et al., “Simultaneous occurrence of benign partial epilepsy and childhood absence epilepsy: report of 2 cases in 2 families,” Epilepsia, 38, S120 (1997).
C. T. Lombroso, “Consistent EEG focalities detected in subjects with primary generalized epilepsies monitored for two decades,” Epilepsia, 38, No. 7, 797-812 (1997).
G. P. Ramelli, F. Donati, H. Moser, and F. Vassella, “Concomitance of childhood absence and rolandic epilepsy,” Clin. Electroencephalogr., 29, No. 4, 177-180 (1998).
P. S. Dimova and D. S. Daskalov, “Coincidence of rolandic and absence features: rare, but not impossible,” J. Child Neurol., 17, No. 11, 838-846 (2002).
M. D. Holmes, M. Brown, and D. M. Tucker, “Are “generalized” seizures truly generalized? Evidence of localized mesial frontal and frontopolar discharges in absence,” Epilepsia, 45, No. 12, 1568-1579 (2004).
M. A. Montenegro and M. M. Guerreiro, “Coexistence of childhood absence and rolandic epilepsy,” J. Child Neurol., 21, No. 6, 535-6 (2006).
T. Glauser, E. Ben-Menachem, B. Bourgeois, et al., “ILAE treatment guideline evidence-based analysis of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes,” Epilepsia, 47, No. 4, 1094–1120 (2006).
R. A. Sarkis, T. Loddenkemper, R. C. Burgess, and E.Wyllie, “Childhood absence epilepsy in patients with benign focal epileptiform discharges”, Pediatr. Neurol., 41, No. 6, 428–434 (2009)
J. P. Manning, D. A. Richards, and N. G. Bowery, “Pharmacology of absence epilepsy,” Trends Pharmacol. Sci., 24, No. 10, 542-549 (2003)
E. B. Posner, K. Mohamed, and A. G. Marson, “Ethosuximide, sodium valproate or lamotrigine for absence seizures in children and adolescents”, Cochrane Database Syst. Rev., 19, N. 4, CD003032 (2003)
P. Loiseau, B. Duche, and J. M. Pedespan, “Absence epilepsies,” Epilepsia, 36, No. 12, 1182-1186 (1995).
C. P. Panayiotopoulos, “Absence epilepsies,” in: Epilepsy, a Comprehensive Textbook, J. J. Engel and T. A. Pedley, eds., Lippincott-Raven Publishers, Philadelphia (1997), pp. 2327-2346.
P. Loiseau, C. P. Panayiotopoulos, and E. Hirsch “Childhood absence epilepsy and related syndromes,” in: Epileptic Syndromes in Infancy, Childhood and Adolescence (3rd ed), J. Roger, M. Bureau, C. Dravet, et al., eds., John Libby and Co Ltd., London (2002), pp. 285-304.
C.P. Panayiotopoulos, “Idiopathic generalised epilepsies,” in: The Epilepsies: Seizures, Syndromes and Management, C. P. Panayiotopoulos, ed., Bladon Medical Publishing, Oxford (2005), pp. 271-348
H. Gastaut, J. L. Gastaut, G. E. Goncalves e Silva, and G. R. Fernandes Sanchez, “Relative frequency of different types of epilepsy: a study employing the classification of the International League against Epilepsy,” Epilepsia, 16, No. 3, 457-461 (1975).
W. A. Hauser, “Seizure disorders: the changes with age,” Epilepsia, 33, Suppl. 4, S6-14 (1992).
E. Granieri, G. Rosati, R. Tola, et al., “A descriptive study of epilepsy in the district of Copparo, Italy, 1964–1978”, Epilepsia, 24, No. 4, 502–514 (1983).
L. Bergamini, S. Bram, S. Broglia and A. Riccio, “L’insorgenza tardiva di crisi Grande Male nel Piccolo Male puro. Studio catamnestico di 78 casi,” Arch. Suisses Neurol. Neurochir. Psychiatr., 96, No. 2, 306-317 (1965).
P. Loiseau, “Childhood absence epilepsy,” in: Epileptic Syndromes in Infancy, Childhood and Adolescence, J. Roger, M. Bureau, C. Dravet, F., et al., eds., John Libbey and Co., London (1992), pp 135-150.
P. Wolf, “Juvenile absence epilepsy,” in: Epileptic Syndromes. J. Roger, M. Bureau, C. Dravet, et al. (eds). John Libbey, London (1985), pp. 242-246.
A. Hedström and I. Olsson, “Epidemiology of absence epilepsy: EEG findings and their predictive value,” Pediatr. Neurol., 7, No. 2, 100-104 (1991).
E. Hirsch, A. Blanc-Platier, and C.Marescaux, “What are the relevant criteria for a better classification of epileptic syndromes with typical absences?” in: Idiopathic Generalized Epilepsies: Clinical, Experimental and Genetic Aspects, A. Malafosse, P. Genton, E. Hirsch, et al., eds., John Libbey and Co., London (1994), pp. 87-93.
E. Wirrell, C. Camfield, P. Camfield, and J. Dooley, “Prognostic significance of failure of the initial antiepileptic drug in children with absence epilepsy,” Epilepsia, 42, No. 6, 760-763 (2001)
P. Loiseau, B. Duche and J. M. Pedespan, “Splitting or lumping absence epilepsies,” Epilepsia, 36, suppl. 4, 116 (1995).
P.Wolf and R. Goosses, “Relation of photosensitivity to epileptic syndromes”, J. Neurol. Neurosurg. Psychiat., 49, No. 12, 1386-1391 (1986).
A. Olsson and A. Hedström, “Epidemiology of absence epilepsy. II. Typical absences in children with encephalopathies,” Acta Paediatr. Scand., 80, No. 2, 235–242 (1991).
R. Massa, A. de Saint-Martin, R. Carcangiu, et al., “EEG criteria predictive of complicated evolution in idiopathic rolandic epilepsy,” Neurology, 57, No. 6, 1071-1079 (2001).
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Maloletnev, V.I., Gugushvili, M.L. & Khachidze, I.O. Comparative Efficacy of Pharmacological Treatment of Absence Epilepsy with Typical and Deviating (Complex) EEG Patterns. Neurophysiology 48, 122–129 (2016). https://doi.org/10.1007/s11062-016-9578-6
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DOI: https://doi.org/10.1007/s11062-016-9578-6