Abstracts

Infantile Epileptic Spasms Syndrome – a Predictive Model for 3-month Electroclinical Remission

Abstract number : 2.53
Submission category : 4. Clinical Epilepsy / 4C. Clinical Treatments
Year : 2024
Submission ID : 1437
Source : www.aesnet.org
Presentation date : 12/8/2024 12:00:00 AM
Published date :

Authors :
Presenting Author: John Mytinger, MD, FAES – Nationwide Children's Hospital, The Ohio State University

Stephanie Ahrens, DO – Nationwide Children's Hospital, The Ohio State University
Dara Albert, DO, MEd – Nationwide Children's Hospital, The Ohio State University
Christopher Beatty, MD, MAS – Nationwide Children's Hospital, The Ohio State University
Darrah Haffner, MD, MHS – Nationwide Children's Hospital, The Ohio State University
Isaiah Metcalf, BA – The Ohio State Univeristy
Adam Ostendorf, MD – Pediatrics, Division of Pediatric Neurology
Anup Patel, MD, FAAN, FAES – Nationwide Children's Hospital, The Ohio State University
Margie Ream, MD, PhD – Pediatrics, Division of Pediatric Neurology
Laurel Slaughter, MD – Nationwide Children's Hospital, The Ohio State University
Jaime Twanow, MD – Nationwide Children's Hospital, The Ohio State University
Jorge Vidaurre, MD – Nationwide Children's Hospital, The Ohio State University
Amanda Weber, DO – Pediatrics, Division of Pediatric Neurology
Steven Rust, PhD – Information Technology Research & Innovation

Rationale: Infantile epileptic spasms syndrome (IESS) is a developmental and epileptic encephalopathy that requires early effective treatment. The clinical variables that determine response to treatment are unknown. The identification of variables that can be modified would inform treatment decisions. The objective of this retrospective consecutive sample cohort study was to develop a predictive model for 3-month electroclinical remission in IESS. We hypothesized that receiving hormone therapy as first treatment would be predictive of 3-month remission.

Methods: We included children presenting to Nationwide Children's Hospital with new-onset IESS between 11/2015 and 2/2024. Children with tuberous sclerosis complex (TSC), who should be treated first with vigabatrin, were excluded. Employing logistic regression, we modeled 3-month remission vs. child characteristics and a combined variable: hormone first + second treatment within 14 days; we used propensity weights determined from a model of hormone first + second treatment within 14 days vs. child characteristics. Hormone first and second treatment within 14 days were combined into a single dependent variable because they were confounding predictors of 3-month remission. Using backward variable elimination, we removed statistically insignificant predictors until the remaining predictors had two-sided P-values of < 5%. A bootstrap procedure was employed to calculate odds ratios and p-values for the remaining predictors.
Clinical Epilepsy