[P1-59] Prognostic Factors in first-drug therapy outcome with Children Absence Epilesy
[Objective] This study compared initial therapy outcomes, and assessed clinical factors and video-electroencephalogram features that may predict treatment response and prognosis. [Methods] From Jan.2010 to Dec. 2015, using “absence seizure” as key words to search CAE in the VEEG database of Nanjing Children’s Hospital Affiliated to Nanjing Medical University. Sixty-seven children were fulfilled the CAE diagnosis criteria of International League Against Epilepsy (ILAE) in 1989. These patients were separated into two groups based on the therapy outcome during half an year, including group 1 (poor therapy outcome), and group 2 (good therapy outcome). We reviewed patients’ clinical characteristics, including age of seizure onset, a family history of epilepsy or febrile seizures (FS) and video- electroencephalogram (VEEG) findings to evaluate the predictive ability of independent variables and the relationship between these features and treatment outcomes using a stepwise multivariate logistic regression model. [Result] The age at seizure onset was 5.89±2.91 (mean±SD), and follow up duration was half an year. Approximately 34.3% of CAE patients had poor response. No statistical correlation was made for sex, age at onset, the occurrence of generalized tonic clonic seizures (GTCS), a family history of febrile seizures or epilepsy between two groups (P > 0.05). Compared with group 2, patients of group 1 had significantly higher rates of focal epileptic discharge (87% vs. 6.8%), higher rates of intermittent photic stimulation (IPS) induced seizures (52.2% vs. 6.8%), fewer rates of occipital intermittent delta activity (OIRDA) (8.7% vs. 77.3%), and fewer rates of patients met the new diagnostic criteria proposed by Panayiotopoulos in 2005 (8.7% vs. 88.6%). The presence of occipital intermittent rhythmic delta activity during wake stage and the interictal focal epileptiform discharges on EEG during sleep stage were significant association with the therapy outcomes in a multivariable logistic regression analysis. [Conclusions] This study showed that the presence of occipital intermittent rhythmic delta activity has a good efficacy, and conversely focal epileptiform discharges was an important factor for first-drug treatment failures with CAE.