Symptomatic and presumed symptomatic focal epilepsies in childhood: An observational, prospective multicentre study.
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Vecchi Marilena, Barba Carmen, De Carlo Debora, Stivala Micol, Guerrini Renzo, Albamonte Emilio, Ranalli Domiziana, Battaglia Domenica, Lunardi Giada, Boniver Clementina, Piccolo Benedetta, Pisani Francesco, Cantalupo Gaetano, Nieddu Giuliana, Casellato Susanna, Cappanera Silvia, Cesaroni Elisabetta, Zamponi Nelia, Serino Domenico, Fusco Lucia, Iodice Alessandro, Palestra Filippo, Giordano Lucio, Freri Elena, De Giorgi Ilaria, Ragona Francesca, Granata Tiziana, Fiocchi Isabella, Bova Stefania Maria, Mastrangelo Massimo, Verrotti Alberto, Matricardi Sara, Fontana Elena, Caputo Davide, Darra Francesca, Dalla Bernardina Bernardo, Beccaria Francesca, Capovilla Giuseppe, Baglietto Maria Pia, Gagliardi Alessandra, Vignoli Aglaia, Canevini Maria Paola, Perissinotto Egle, Francione Stefano
Аннотация
METHODS: In this observational, multicenter, nationwide study, children (age 1 month-12.9 years) with a new diagnosis of symptomatic or presumed symptomatic focal epilepsy were consecutively enrolled in 15 Italian tertiary childhood epilepsy centers. Inclusion criteria were as follows: (1) diagnosis of symptomatic focal epilepsy due to acquired and developmental etiologies, and presumed symptomatic focal epilepsy; (2) age at diagnosis older than 1 month and <13 years; and (3) written informed consent. Children were subdivided into three groups: ≤3 years, >3 to 6 years, and >6 years. Clinical, electroencephalography (EEG), neuroimaging, and neuropsychological variables were identified for statistical analyses.
RESULTS: Two hundred fifty-nine children were enrolled (116 female and 143 male). Median age: 4.4 years (range 1 month-12.9 years); 46.0% (n = 119) of children were younger than 3 years, 24% (61) from 3 to 6 years of age, and 30% (79) older than 6 years. Neurologic examination findings were normal in 71.8%. Brain magnetic resonance imaging (MRI) was abnormal in 59.9%. Children age ≤3 years experienced the highest seizure frequency in the first month after recruitment (p < 0.0001). Monotherapy in the first month was used in 67.2%. Cognitive tests at baseline revealed abnormal scores in 30%; behavioral problems were present in 21%. At multivariate analysis, higher chances to exhibit more than five seizures in the first month after epilepsy onset was confirmed for younger children and those with temporal lobe epilepsy.
SIGNIFICANCE: In this prospective cohort study, an extensive characterization of epilepsy onset in children with symptomatic or presumed symptomatic focal epilepsies is reported in relation to the age group and the localization of the epileptogenic zone.