1. Symptomatic and presumed symptomatic focal epilepsies in childhood: An observational, prospective multicentre study
- Author
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Francesca Ragona, Carmen Barba, Alberto Verrotti, Susanna Casellato, Maria Paola Canevini, Alessandro Iodice, Micol Stivala, Giada Lunardi, Stefano Francione, Massimo Mastrangelo, Domenico Serino, Tiziana Granata, Benedetta Piccolo, D De Carlo, Gaetano Cantalupo, Stefania Maria Bova, Francesco Pisani, Isabella Fiocchi, Domenica Battaglia, Renzo Guerrini, Egle Perissinotto, Giuseppe Capovilla, Davide Caputo, Maria Pia Baglietto, Emilio Albamonte, Elena Fontana, Domiziana Ranalli, Nelia Zamponi, Filippo Palestra, Ilaria De Giorgi, Marilena Vecchi, Sara Matricardi, Bernardo Dalla Bernardina, Francesca Darra, Elena Freri, Lucia Fusco, Silvia Cappanera, Aglaia Vignoli, Elisabetta Cesaroni, Lucio Giordano, Clementina Boniver, Alessandra Gagliardi, Giuliana Nieddu, and Francesca Beccaria
- Subjects
Male ,Pediatrics ,Behavior impairment ,Childhood epilepsy ,Cognitive function ,Focal symptomatic seizures ,Intractable epilepsy ,Neurology ,Neurology (clinical) ,Epilepsies ,Neuropsychological Tests ,Cohort Studies ,Epilepsy ,0302 clinical medicine ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Child ,Prospective cohort study ,education.field_of_study ,Brain ,Electroencephalography ,Magnetic Resonance Imaging ,Child, Preschool ,Cohort ,Female ,Partial ,Cohort study ,medicine.medical_specialty ,Adolescent ,Age Distribution ,Cognition Disorders ,Epilepsies, Partial ,Humans ,Infant ,Infant, Newborn ,Population ,03 medical and health sciences ,Settore MED/39 - NEUROPSICHIATRIA INFANTILE ,Preschool ,education ,business.industry ,Newborn ,medicine.disease ,El Niño ,Etiology ,business ,030217 neurology & neurosurgery - Abstract
To describe the clinical, neuropsychological, and psychopathologic features of a cohort of children with a new diagnosis of symptomatic or presumed symptomatic focal epilepsy at time of recruitment and through the first month. The selected population will be followed for 2-5 years after enrollment to investigate the epilepsy course and identify early predictors of drug resistance.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 and13 years; and (3) written informed consent. Children were subdivided into three groups: ≤3 years,3 to 6 years, and6 years. Clinical, electroencephalography (EEG), neuroimaging, and neuropsychological variables were identified for statistical analyses.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 (p0.0001). 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.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.
- Published
- 2016
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