Med. Bull. Fukuoka Univ.403/4105 1102013 Clinical Course and EEG Findings of 25 Patients Initially Diagnosed with Childhood Absence Epilepsy Noriko NAKAMURA, Sawa YASUMOTO, Takako FUJITA, Yuko TOMONOH, Yukiko IHARA, Shinya NINOMIYA, Hiroshi IDEGUCHI, Takahito INOUE and Shinichi HIROSE Department of Pediatrics, Faculty of Medicine, Fukuoka University Abstract Rationale: The prognosis of childhood absence epilepsy CAEis good, and remission usually occurs before the age of 12 years. However, some patients progress to juvenile myoclonic epilepsy JME, requiring continuous treatment after adolescence. Purpose: To determine the risk factors for being unable to discontinue treatment for CAE during childhood. Methods: We divided the 25 patients with CAE into two groups according to their clinical course: Group A included nine patients who could not discontinue treatment during childhood and group B included 16 patients who discontinued treatment because of remission. We evaluated both the EEG findings and the clinical aspects of patients initially diagnosed with CAE. Results: 1All 25 patients started with typical absence seizures TAS, and 44% of the patients in group A developed generalized tonic-clonic seizures GTCSconcomitant with the stage of active TAS 2The EEG findings of group A showed that six patients had a photoparoxysmal response PPRon inter-ictal EEG, seven patients had focal spike and wave complexes SWCin the frontal lobe. The EEG findings of group B showed that two patients had PPR and one patient had focal SWC in the frontal lobe. Three patients 12% progressed to juvenile absence epilepsy and two patients 8%progressed to JME. Conclusions: The risk factors for a worse prognosis of CAE are GTCS observed during the active stage of TAS, PPR or focal SWC in the frontal lobe. Key wordsgeneralized tonic-clonic seizures, Juvenile myoclonic epilepsy, Photoparoxysmal responses, Focal spike and wave complexes, Juvenile absence epilepsy 25 CAE 12 JME CAE CAE 25 A 9 814-0180 7 45-1 Tel: 092-801-1011Fax: 092-863-1970E-mail: nor-naka@live.jp
106 B 16 A 4 44 GTCS 3Hz A 6 66B 2 12, A 7 78B 1 6 3 12 JME 2 8 CAE GTCS Childhood absence epilepsy : CAE Typical absence seizures : TAS CAE 12 1 generalized tonic-clonic seizures : GTCS Juvenile myoclonic epilepsy :JME 2 25 1979 2002 CAE 25 A B A 9 1 8 B 16 6 10
25 107 1 A 2 9 7.1 B 3 10 6.6 A 22 B 31 A 55 B 12 TAS A 44 TAS GTCS VPAA 77B 56 A 1 VPA B 5 B 1 B 1 A 1 A 9.6 B 5.4 A 2 3 B 1 6 3Hz A 67 6 33 1 2 10 B 6 3Hz 3 5 A 33 B 31 A 22B 19 B 6 0 B A 2 A GTCS 1 3 20 1 JME GTCS 3 JAE GTCS 21 JME JME 20 3 3Hz A 78 B 6A A 66 B 12A CAE 1989 ILAE A
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