دورية أكاديمية
Oligoepilepsy and lifelong seizure susceptibility in epilepsy with generalized tonic-clonic seizures alone: Experience at an adult tertiary center.
| العنوان: | Oligoepilepsy and lifelong seizure susceptibility in epilepsy with generalized tonic-clonic seizures alone: Experience at an adult tertiary center. |
|---|---|
| المؤلفون: | Peña-Ceballos J; Department of Neurology, Beaumont Hospital, Dublin, Ireland., Moloney PB; Department of Neurology, Beaumont Hospital, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland; FutureNeuro, the Science Foundation Ireland Research Centre for Chronic and Rare Neurological Diseases, Dublin, Ireland., Kilbride RD; Department of Neurology, Beaumont Hospital, Dublin, Ireland., Naggar HE; Department of Neurology, Beaumont Hospital, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland; FutureNeuro, the Science Foundation Ireland Research Centre for Chronic and Rare Neurological Diseases, Dublin, Ireland., Widdess-Walsh P; Department of Neurology, Beaumont Hospital, Dublin, Ireland., Delanty N; Department of Neurology, Beaumont Hospital, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland; FutureNeuro, the Science Foundation Ireland Research Centre for Chronic and Rare Neurological Diseases, Dublin, Ireland. Electronic address: normandelanty@beaumont.ie. |
| المصدر: | Epilepsy research [Epilepsy Res] 2024 May; Vol. 202, pp. 107362. Date of Electronic Publication: 2024 Apr 19. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Science Publishers Country of Publication: Netherlands NLM ID: 8703089 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-6844 (Electronic) Linking ISSN: 09201211 NLM ISO Abbreviation: Epilepsy Res Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Amsterdam : Elsevier Science Publishers, c1987- |
| مواضيع طبية MeSH: | Anticonvulsants*/therapeutic use , Seizures*/drug therapy , Seizures*/physiopathology , Epilepsy, Generalized*/drug therapy , Epilepsy, Generalized*/physiopathology, Humans ; Adult ; Female ; Male ; Middle Aged ; Young Adult ; Adolescent ; Retrospective Studies ; Aged ; Tertiary Care Centers ; Treatment Outcome |
| مستخلص: | Objective: Epilepsy with generalized tonic-clonic seizures alone (GTCA) is the least studied syndrome within the idiopathic generalized epilepsy (IGE) spectrum. We characterize a large cohort of adult patients with GTCA to understand natural history and drug responsiveness. Methods: In this retrospective single-center study using our epilepsy electronic record, we evaluated clinical characteristics, seizure outcomes, anti-seizure medication (ASM) response including seizure recurrence after ASM withdrawal, and sex differences in a cohort of GTCA patients aged ≥17 years. Results: Within a cohort of 434 IGE patients, 87 patients (20 %) with GTCA were included. The mean age was 34.9 years (range 17-73 years). Forty-six patients (52.8 %) were females. Seventy-two patients (82.8 %) were seizure-free and 15 (17.2 %) had active epilepsy over the previous 12 months. Thirty-four patients (39.1 %) had ≤5 lifetime seizures, aligning with a prior definition of 'oligoepilepsy'. Sixty-five patients (74.7 %) were treated with monotherapy, 19 (21.8 %) were treated with polytherapy, and three were not taking any ASM. Levetiracetam (37.9 %) was the most commonly prescribed ASM, followed by lamotrigine (32.1 %) and valproate (31 %). Seventeen patients (19.5 %) attempted to withdraw their ASM. The rate of seizure recurrence after ASM withdrawal was 88.2 % (15/17), including two patients who relapsed more than 20 years after ASM discontinuation. Females had more seizures in their lifetime and had trialed more ASM compared to males. Significance: GTCA has a relatively good prognosis, with most patients becoming seizure-free on monotherapy. The high rate of seizure recurrence after ASM withdrawal supports lifetime seizure susceptibility. We found potential sex differences in seizure outcomes and ASM response, although further research is needed to validate this finding. Competing Interests: Conflict of Interest JPC served as a speaker and received travel expenses from Angelini Pharma. PBM served on an advisory board for Angelini Pharma and received travel expenses from UCB Pharma. RDK and HEN reported no conflicts of interest. Over the last three years, PWW has served as a speaker for Angelini Pharma and Jazz Pharmaceuticals, and ND has served as a paid advisor and/or speaker for Angelini Pharma, Eisai, Radius Pharma, and UNEEG Medical. (Copyright © 2024 Elsevier B.V. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Anti-seizure medication; Drug resistance; Epilepsy with generalized tonic-clonic seizures alone; Idiopathic generalized epilepsy |
| المشرفين على المادة: | 0 (Anticonvulsants) |
| SCR Disease Name: | Epilepsy, Idiopathic Generalized |
| تواريخ الأحداث: | Date Created: 20240423 Date Completed: 20240501 Latest Revision: 20240501 |
| رمز التحديث: | 20240502 |
| DOI: | 10.1016/j.eplepsyres.2024.107362 |
| PMID: | 38652996 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1872-6844 |
|---|---|
| DOI: | 10.1016/j.eplepsyres.2024.107362 |