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