[P2-159] Spectrum of Epilepsy in Children with Tuberous Sclerosis Complex: A Developing Country Perspective
Introduction: To describe the pattern of epilepsy, response to the treatment and comorbidities in children aged 0-14 years with tuberous sclerosis complex (TSC) in a developing country
Methodology: Cross-sectional study.
Study setting: Epilepsy and Neurodevelopment Clinics of a tertiary care hospital.
Results: 47 children (72% males) were studied. Mean ages at diagnosis and enrollment were 27.1 months (2-120 months) and 77.6 months (14-166 months) respectively. Mean duration of follow-up was 43.4 months (7-143 months). All patients had seizures (100%); mean age at first seizure was 16.4 months (0.1-120 months). Majority had atleast two (44.6%) followed by single (34%) and three (10.6%) types of seizures. Seizures were focal (76.6%), infantile spasm (48.9%), generalized tonic-clonic (40.4%), generalized tonic (12.7%), myoclonic (6.4%), gelastic (6.4%), absence (6.4%), atonic (2.1%) and electrical status (2.1%). Mean number of antiepileptic-drugs used were 3.4 (range 1-8); sodium valproate (82.9%) use was most common. 55% patients were in remission (38% for 1year, 23% for 6months, 19% for 2years, 11.5% for 4 and 5years each). Drug-resistant epilepsy was noted in 40.4% patients. 21% children with TSC had development quotient (DQ) >85; majority (48.9%) showed improvement after epilepsy control. Six (12.7%) children had autism; 2 showed improvement after epilepsy-control. Twenty (42.5%) patients had behavioral problems; 2 showed improvement after epilepsy-control.
Conclusions: The pattern of epilepsy in children with TSC varies over a spectrum. Epilepsy follow-up is needed to monitor for developmental problems and drug-resistance to anti-epileptic drugs.
Methodology: Cross-sectional study.
Study setting: Epilepsy and Neurodevelopment Clinics of a tertiary care hospital.
Results: 47 children (72% males) were studied. Mean ages at diagnosis and enrollment were 27.1 months (2-120 months) and 77.6 months (14-166 months) respectively. Mean duration of follow-up was 43.4 months (7-143 months). All patients had seizures (100%); mean age at first seizure was 16.4 months (0.1-120 months). Majority had atleast two (44.6%) followed by single (34%) and three (10.6%) types of seizures. Seizures were focal (76.6%), infantile spasm (48.9%), generalized tonic-clonic (40.4%), generalized tonic (12.7%), myoclonic (6.4%), gelastic (6.4%), absence (6.4%), atonic (2.1%) and electrical status (2.1%). Mean number of antiepileptic-drugs used were 3.4 (range 1-8); sodium valproate (82.9%) use was most common. 55% patients were in remission (38% for 1year, 23% for 6months, 19% for 2years, 11.5% for 4 and 5years each). Drug-resistant epilepsy was noted in 40.4% patients. 21% children with TSC had development quotient (DQ) >85; majority (48.9%) showed improvement after epilepsy control. Six (12.7%) children had autism; 2 showed improvement after epilepsy-control. Twenty (42.5%) patients had behavioral problems; 2 showed improvement after epilepsy-control.
Conclusions: The pattern of epilepsy in children with TSC varies over a spectrum. Epilepsy follow-up is needed to monitor for developmental problems and drug-resistance to anti-epileptic drugs.