Syndromic Classification in Patients with Typical Absence Seizures.
Abstract number :
2.095
Submission category :
Year :
2001
Submission ID :
1189
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
L.M.F.F. Guilhoto, MD,PhD, Neurology, Hospital das Clinicas da FMUSP, Sao Paulo, Brazil; E.M.T. Yacubian, MD, PhD, Neurology, Hospital das Clinicas da FMUSP, Sao Paulo, Brazil; M.L.G. Manreza, MD, PhD, Neurology, Hospital das Clinicas da FMUSP, Sao Paulo,
RATIONALE: The aim of this paper is to describe 43 patients with typical absences (TA) and to classify them according to the ILAE[ssquote]s Classification (1989) and to Panayiotopoulos[ssquote] criteria (1997) and compare both classifications, evaluating prognostic implications.
METHODS: We studied by video-EEG 43 patients with TA (ILAE, 1981) that had normal neurological and neurorradiological examination and interictal EEG with spike-wave complexes (SWC) with frequencies higher than 2.5Hz. 455 seizures were analyzed. We utilized very rigorously the criteria of the ILAE[scquote]s Classification and Panayiotopoulos[scquote] proposal (1997) to classify these patients.
RESULTS: A syndromic diagnosis was possible according to ILAE[scquote]s criteria and Panayiotopoulos[scquote] proposal in 60.46% and 67.44% of the patients, respectively. Eleven patients (25.58%) did not present electroclinical characteristics that could permit the inclusion in the syndromes described. According to ILAE[scquote]s criteria 19 patients were classified as childhood absence epilepsy (CAE), 5 as juvenile absence epilepsy (JAE), one as juvenile myoclonic epilepsy (JME) and one that had absences precipitated by photostimulation as epilepsy with specific modes of seizure precipitation. According to Panayiotopoulos[scquote] proposal we could classify the patients in the following groups: CAE (10 pt), JAE (14 pt), JME (1 pt), myoclonic absence epilepsy (3 pt), eyelid myoclonia with absences (1 pt). In the cases with different diagnosis, the greater discrepancy was found in the groups of CAE and JAE. ILAE[scquote]s classification permitted to group under the diagnosis of CAE a greater (n=19) number of cases than Panayiotopoulos[scquote] proposal (n=10), and contrarily in this latter group, a greater number of patients received the diagnosis of JAE (n=14) when compared to the first classification (n=5). In the patients that were classified as CAE in ILAE[scquote]s classification and as JAE in Panayiotopoulos[scquote] proposal we observed a mean age of onset older (8.62y) than the patients classified as CAE according to this author (5.20y).
CONCLUSIONS: In the present study of 43 patients with typical absence seizures the syndromic approach was performed in 60.46% and 67.44% of the cases according to ILAE[scquote]s and Panayiotopoulos[scquote] criteria, respectively. We believe that the different syndromes are probable genetically distinct subgroups, that according to individual seizure susceptibility and exposition to acquired factors, could manifest in continuity, being grouped in relatively specific entities of higher prevalence that would permit categorization of syndromes and isolated cases, that could not fit in nosological classifications neither have a prognostic approach.
Support: CNPq.