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The severity of seizures and epileptiform activity index in the assessment of antiepileptic treatment efficacy in patients with generalized tonic-clonic awakening seizures

https://doi.org/10.17749/2077-8333/epi.par.con.2021.091

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Abstract

Objective: to evaluate the role of seizure severity and epileptiform activity index (IEA) assessment in newly-diagnosed idiopathic generalized epilepsy with generalized tonic-clonic awakening seizures (GTCS).
Material and methods. The study included 31 patients with newly-diagnosed generalized epilepsy with GTCS aged 14–52 years (mean age 25.06±9.3 years), which were divided into two groups depending on seizure severity: Group 1 (n=9, 29%) with <18 points, and Group 2 (n=22, 71%) with ≥18 points. Seizure severity was analysed by using National Hospital Seizure Severity Scale (NHS3). All patients underwent video-electroencephalography monitoring (8–24 hours) with IEA assessment at baseline and at 1, 3, 6 and 12 months after the beginning of treatment. Therapeutic efficacy was assessed using the criteria of seizure absence (medically induced remission), seizure rate decrease by >50% (responders), seizure rate decrease by <50% (insufficient efficacy), seizure rate increase and retention in treatment.
Results. Total EAI at baseline was significantly higher in patients from Group 2 (p=0.019). Despite markedly reduced EAI level in both groups, in Group 1 (less than 18 points by NHS3) EAI was significantly lower compared to Group 2 (≥18 points) at all subsequent visits: visit 2 (p=0.038), visit 3 (p=0.035), visit 4 (p=0.047), and visit 5 (p=0.022).
Conclusions. Assessing seizure severity may become an additional objective criterion while evaluating treatment efficacy.

About the Authors

V. A. Karlov
Yevdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Vladimir А. Karlov – Dr. Med. Sc., Corresponding Member of RAS, Professor, Department of Nervous Diseases, Medical Faculty

20/1 Delegatskaya Str., Moscow 127473

Scopus Author ID: 7103065003

RSCI SPIN-code: 2726-9790



A. B. Kozhokaru
Russian State Research Center – Burnasyan Federal Medical Biophysical Center, Federal Medical Biological Agency of Russia; Central State Medical Academy of the Presidential Administration of the Russian Federation
Russian Federation

Anzhela B. Kozhokaru – MD, PhD, Head of Department of Clinical Neurophysiology

46 Zhivopisnaya Str., Moscow 123098

19 bld. 1A Marshal Timoshenko Str., Moscow 121359

Scopus Author ID: 28367717700

RSCI SPIN-code: 9567-7212



P. N. Vlasov
Yevdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Pavel N. Vlasov – Dr. Med. Sc., Professor, Chair of Nervous Diseases, Medical Faculty

20/1 Delegatskaya Str., Moscow 127473

Scopus Author ID: 7101688064

RSCI SPIN-code: 9357-2284



A. S. Orlova
Sechenov University
Russian Federation

Aleksandra S. Orlova – MD, PhD, Associate Professor, Chair of Human Pathology

8/2 Trubetskaya Str., Moscow 119991

WoS ResearcherID: F-6886-2016

Scopus Author ID: 57191331064

RSCI SPIN-code: 6468-5100



References

1. Karlov V.А. Epilepsy in children and adult women and men. A guide for doctors. 2nd ed. Мoscow: BINOM; 2019: 896 p. (in Russ.).

2. Karlov V.A., Guekht A.B., Guzeva V.I., et al. Algorithms of mono- and polytherapy in clinical epileptology. Part 1. General principles of drug choice. S.S. Korsakov Journal of Neurology and Psychiatry. 2016; 116 (6): 109–14 (in Russ.). https://doi.org/10.17116/JNEVRO201611661109-114.

3. Leach J.P. Treatment of epilepsy – towards precision. F1000Res. 2018; 7: F1000 Faculty Rev-1932. https://doi.org/10.12688/f1000research.16448.1.

4. Kanner A.M., Ashman E., Gloss D., et al. Practice guideline update summary: efficacy and tolerability of the new antiepileptic drugs I: treatment of new-onset epilepsy. Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2018; 91 (2): 74–81. https://doi.org/10.1212/WNL.0000000000005755.

5. Cramer J.A., French J. Quantitative assessment of seizure severity for clinical trials: a review of approaches to seizure components. Epilepsia. 2001; 42 (1): 119–29. https://doi.org/10.1046/j.1528-1157.2001.19400.x.

6. Perucca E. Evaluation of drug treatment outcome in epilepsy: a clinical perspective. Pharm World Sci. 1997; 19 (5): 217–22. https://doi.org/10.1023/a:1008698807530.

7. Zou X., Hong Z., Chen J., Zhou D. Is antiepileptic drug withdrawal status related to quality of life in seizure-free adult patients with epilepsy? Epilepsy Behav. 2014; 31: 129–35. https://doi.org/10.1016/j.yebeh.2013.11.028.

8. Karlov V.А., Vlasov P.N., Khabibova А.О. The possibilities of formalized methods in objectifying the dynamics of the severity of epilepsy course. Neurology Bulletin. 1998; 29 (1-2): 30–3 (in Russ.).

9. Karlov V.А, Khabibova А.О. Quality of life in psychoneurology. Abstracts of the reports of the international conference. Saint Petersburg; 2000 (in Russ.).

10. Karlov V.A., Kozhokaru A.B., Vlasov P.N., et al. Dynamics of epileptiform activity, efficacy and tolerability of valproic acid in adults and adolescents with newly-diagnosed epilepsy. S.S. Korsakov Journal of Neurology and Psychiatry. 2020; 120 (7): 35–43 (in Russ.). https://doi.org/10.17116/jnevro202012007135.

11. O’Donoghue M.F., Duncan J.S., Sander J.W. The National Hospital Seizure Severity Scale: a further development of the Chalfont Seizure Severity Scale. Epilepsia. 1996; 37 (6): 563–71. https://doi.org/10.1111/j.1528-1157.1996.tb00610.x.

12. Andermann F., Berkovic S.F. Idiopathic generalized epilepsy with generalized and other seizures in adolescence. Epilepsia. 2001; 42 (3): 317–20. https://doi.org/10.1046/j.1528-1157.2001.36400.x.

13. Engel J. Jr. A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE Task Force on Classification and Terminology. Epilepsia. 2001; 42 (6): 796–803. https://doi.org/10.1046/j.1528-1157.2001.10401.x.

14. Melikyan E.G., Gekht A.B. Investigation of frequency and severity of epileptic seizures effect on quality of life in patients with epilepsy. Bulletin of Pirogov National Medical & Surgical Center. 2010; 5 (3): 116–21 (in Russ.).

15. Cramer J.A. Assessing the severity of seizures and epilepsy: which scales are valid? Curr Opin Neurol. 2001; 14 (2): 225–9. https://doi.org/10.1097/00019052-200104000-00015.

16. Aghaei-Lasboo A., Fisher R.S. Methods for measuring seizure frequency and severity. Neurol Clin. 2016; 34 (2): 383–94. https://doi.org/10.1016/j.ncl.2015.11.001.

17. Todorova K.S., Velikova V.S., Kaprelyan A.G., Tsekov S.T. Seizure severity as an alternative measure of outcome in epilepsy. J IMAB. 2013; 19 (3): 433–7. https://doi.org/10.5272/jimab.2013193.433.

18. Kwan P., Brodie M.J. Neuropsychological effects of epilepsy and antiepileptic drugs. Lancet. 2001; 357 (9251): 216–22. https://doi.org/10.1016/s0140-6736(00)03600-x.

19. Bautista R.E., Glen E.T. Seizure severity is associated with quality of life independent of seizure frequency. Epilepsy Behav. 2009; 16 (2): 325–9. https://doi.org/10.1016/j.yebeh.2009.07.037.

20. Tilz C., Stefan H., Hopfengaertner R., et al. Influence of levetiracetame on ictal and postictal EEG in patients with partial seizures. Eur J Neurol. 2006; 13 (12): 1352–8. https://doi.org/10.1111/j.1468-1331.2006.01516.x.

21. Karlov В.А., Khabibova А.О. Modern methods of diagnosis and treatment of epilepsy. Smolensk; 1997: 76–7 (in Russ.).


For citation:


Karlov V.A., Kozhokaru A.B., Vlasov P.N., Orlova A.S. The severity of seizures and epileptiform activity index in the assessment of antiepileptic treatment efficacy in patients with generalized tonic-clonic awakening seizures. Epilepsy and paroxysmal conditions. 2021;13(3):192-199. (In Russ.) https://doi.org/10.17749/2077-8333/epi.par.con.2021.091

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ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online)