TY - JOUR
T1 - Early predictors of remission in children and adolescents with new-onset epilepsy
T2 - A prospective study
AU - Ayoub, Dana
AU - Al-Hajje, Amal
AU - Salameh, Pascale
AU - Jost, Jeremy
AU - Hmaimess, Ghassan
AU - Nasreddine, Wassim
AU - Jaafar, Fatima
AU - Wazne, Jaafar
AU - Bitar, Ribal
AU - Sabbagh, Sandra
AU - Boumediene, Farid
AU - Beydoun, Ahmad
N1 - Publisher Copyright:
© 2023 British Epilepsy Association
PY - 2023/8
Y1 - 2023/8
N2 - Purpose: This study aims to identify predictive factors of a two-year remission (2YR) in a cohort of children and adolescents with new-onset seizures based on baseline clinical characteristics, initial EEG and brain MRI findings. Methods: A prospective cohort of 688 patients with new onset seizures, initiated on treatment with antiseizure medication was evaluated. 2YR was defined as achieving at least two years of seizure freedom during the follow-up period. Multivariable analysis was performed and recursive partition analysis was utilized to develop a decision tree. Results: The median age at seizure onset was 6.7 years, and the median follow-up was 7.4 years. 548 (79.7%) patients achieved a 2YR during the follow up period. Multivariable analysis found that presence and degree of intellectual and developmental delay (IDD), epileptogenic lesion on brain MRI and a higher number of pretreatment seizures were significantly associated with a lower probability of achieving a 2YR. Recursive partition analysis showed that the absence of IDD was the most important predictor of remission. An epileptogenic lesion was a significant predictor of non-remission only in patients without evidence of IDD, and a high number of pretreatment seizures was a predictive factor in children without IDD and in the absence of an epileptogenic lesion. Conclusion: Our results indicate that it is possible to identify patients at risk of not achieving a 2YR based on variables obtained at the initial evaluation. This could allow for a timely selection of patients who require close follow-up, consideration for neurosurgical intervention, or investigational treatments trials.
AB - Purpose: This study aims to identify predictive factors of a two-year remission (2YR) in a cohort of children and adolescents with new-onset seizures based on baseline clinical characteristics, initial EEG and brain MRI findings. Methods: A prospective cohort of 688 patients with new onset seizures, initiated on treatment with antiseizure medication was evaluated. 2YR was defined as achieving at least two years of seizure freedom during the follow-up period. Multivariable analysis was performed and recursive partition analysis was utilized to develop a decision tree. Results: The median age at seizure onset was 6.7 years, and the median follow-up was 7.4 years. 548 (79.7%) patients achieved a 2YR during the follow up period. Multivariable analysis found that presence and degree of intellectual and developmental delay (IDD), epileptogenic lesion on brain MRI and a higher number of pretreatment seizures were significantly associated with a lower probability of achieving a 2YR. Recursive partition analysis showed that the absence of IDD was the most important predictor of remission. An epileptogenic lesion was a significant predictor of non-remission only in patients without evidence of IDD, and a high number of pretreatment seizures was a predictive factor in children without IDD and in the absence of an epileptogenic lesion. Conclusion: Our results indicate that it is possible to identify patients at risk of not achieving a 2YR based on variables obtained at the initial evaluation. This could allow for a timely selection of patients who require close follow-up, consideration for neurosurgical intervention, or investigational treatments trials.
KW - Children and adolescents
KW - Epileptogenic lesion
KW - Intellectual and developmental delay
KW - New-onset seizures
KW - Number of pretreatment seizures
KW - Remission
UR - http://www.scopus.com/inward/record.url?scp=85162866648&partnerID=8YFLogxK
U2 - 10.1016/j.seizure.2023.06.007
DO - 10.1016/j.seizure.2023.06.007
M3 - Article
C2 - 37327752
AN - SCOPUS:85162866648
SN - 1059-1311
VL - 110
SP - 69
EP - 77
JO - Seizure
JF - Seizure
ER -