Objective: To evaluate seizure semiology and electroencephalogram (EEG) characteristics in children with newly diagnosed childhood absence epilepsy (CAE) for seizure outcomes.

Methods. The video-EEG recordings of 164 electrographic absence seizures were re-analyzed in a sample of 41 patients. The seizure semiology and EEG characteristics were analyzed as predictors of outcomes at the 3rd, 6th, 12th, and 24th months.

Results. Besides hallmark manifestations, additional semiology features were identified in 87.9% of patients (86.6% of seizures). Automatism and eye blinking were observed at rates of 68.3% and 66.5%, respectively. The seizure duration was significantly greater in the presence of both automatisms and eye involvement as compared to the group without these features (mean duration: 13.5 seconds vs. 7.6 seconds; p=0.001). The presence of vocal characteristics of the seizure, polyspike and wawe discharges, and poor synchronization of ictal EEG features were associated with poor seizure outcomes in the first year. The existence of eye deviation and ‘lead in’ the ictal EEG were found to be significantly linked to poor seizure outcomes for the entire duration of the follow-up period (p<0.05). Although the presence of head retropulsation were not associated with seizure outcomes, there was a significant association with EEG outcomes. The seizure burden during the hyperventilation period was a satisfactory predictor of poor seizure outcome at the 3rd month (p=0.048).

Conclusions. The semiologic features, including ocular deviation, vocal characteristics, and head retropulsion, and the ictal EEG features, such as poor synchronization and ‘lead in', are the main outcome predictors in patients with CAE.

Seda Kanmaz
Ege University Medical Faculty
Turkey

Irem Kayikcioglu
Ege University Medical Faculty
Turkey

Hulya Kayilioglu
Muğla Sıtkı Kocman University Medical Faculty
Turkey

Ayfer Arduc Akcay
Koc University Medical Faculty
Turkey

Gul Aktan
Ege University Medical Faculty
Turkey

Sarenur Gokben
Ege University Medical Faculty
Turkey

Hasan Tekgul
Ege University Medical Faculty
Turkey

Sanem Yilmaz
Ege University Medical Faculty
Turkey