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
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. KarlovRussian 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 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
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
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
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Review
For citations:
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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