De novo Absence Status Epilepticus in a pediatric cohort: Electroclinical pattern in a multicenter Italian patients cohort

Seizure. 2019 Dec:73:79-82. doi: 10.1016/j.seizure.2019.10.021. Epub 2019 Nov 10.

Abstract

Purpose: Absence Status epilepticus (AS) is a form of Non Convulsive Status Epilepticus defined as a prolonged, generalized and non-convulsive seizure, with an altered content of consciousness. We aim to describe a group of healthy children, who presented recurrent and unprovoked de novo AS as the only manifestation of their epilepsy, with an excellent response to antiepileptic drugs.

Method: We retrospectively reviewed the electroclinical and genetic features of 13 pediatric patients, referring to our epilepsy centers from 2005 to 2019, on the following criteria: (1) regular psychomotor development, (2) one or more unprovoked AS as the only epileptic manifestation, (3) normal blood testing, (4) normal neuroimaging, (5) EEG recording, (6) available follow-up (1-14 years).

Results: Patients are 7 females and 6 males, aged 7-22, with a mean age at AS onset of 9,3 years. All of them started an antiepileptic therapy, with an excellent response to Valproic Acid (VPA) or Ethosuximide (ETS). 5 patients did not start the therapy immediately after the first AS and they presented recurrent AS (from 2 to 4 episodes). 10 of them performed aCGH, karyotype, NGS panel or Whole Exome Sequencing.

Conclusions: We suggest that de novo AS may be a well-defined age-related and self-limited epilepsy syndrome, with a good prognosis and excellent response to therapy, but it comes with a high risk of relapsing if not adequately treated with antiepileptic drugs.

Keywords: Absence; Genetic epilepsy; NCSE.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Anticonvulsants / therapeutic use
  • Child
  • Electroencephalography
  • Epilepsy / drug therapy
  • Epilepsy / physiopathology*
  • Ethosuximide / therapeutic use
  • Female
  • Humans
  • Italy
  • Male
  • Retrospective Studies
  • Status Epilepticus / drug therapy
  • Status Epilepticus / physiopathology*
  • Valproic Acid / therapeutic use
  • Young Adult

Substances

  • Anticonvulsants
  • Ethosuximide
  • Valproic Acid