KMID : 1151120200280030100
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Annals of Child Neurology 2020 Volume.28 No. 3 p.100 ~ p.106
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Prognostic Factors of Patients with Postinfantile Epilepsy and Multiple Independent Spike Foci on Electroencephalography
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Kong Ju-Hyun
Lee Yun-Jin Ko A-Ra Kim Young-Mi Yeon Gyu-Min Nam Sang-Ook
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Abstract
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Purpose: Multiple independent spike foci (MISF) have been reported to be associated with hypsarrhythmia and slow spikes and waves. However, some patients with MISF demonstrate a good prognosis, such as benign focal epilepsy. This study aimed to elucidate the prognosis of epileptic children with MISF and to analyze the prognostic factors.
Methods: The subjects were 115 epileptic children aged 1 to 18 years who visited Pusan National University Children¡¯s Hospital between November 2008 and July 2016 and in whom MISF were noted on electroencephalography. We excluded patients with infantile spasms, congenital metabolic diseases, neurodegenerative diseases, or post-encephalitic epilepsy. We retrospectively reviewed participants¡¯ clinical information. Seizure control was defined as no seizures over 6 months at the last visit. Prognostic factors were analyzed in the seizure control (group A; 84 [73%]) and no seizure control (group B; 31 [27%]) groups.
Results: Generalized seizure (P=0.033), intellectual disability (P<0.001), cerebral palsy (P=0.046), and abnormal background activity and electrodecrements on electroencephalography (P<0.001) were significantly more common in group B. No clinically significant abnormalities were noted on magnetic resonance imaging of the brain. The MISF improved on follow-up electroencephalography in 58 (71.6%) patients in group A versus 10 (35.7%) in group B (P=0.002).
Conclusion: Despite MISF on electroencephalography, two-thirds of patients had a benign clinical course, particularly those with post-infantile epilepsy and no infantile spasms. The prognostic factors of poor outcomes were generalized seizures, intellectual disability, and abnormal background activity on electroencephalography.
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KEYWORD
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Child, Electroencephalography, Epilepsy, Prognosis
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