z-logo
Premium
Tonic‐clonic seizures in idiopathic generalized epilepsies: Prevalence, risk factors, and outcome
Author(s) -
AsadiPooya Ali A.,
Homayoun Maryam
Publication year - 2020
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13227
Subject(s) - medicine , idiopathic generalized epilepsy , ictal , epilepsy , pediatrics , seizure types , electroencephalography , anesthesia , retrospective cohort study , age of onset , disease , psychiatry
Purpose We investigated the prevalence of generalized tonic‐clonic seizures (GTCSs) in patients with idiopathic generalized epilepsy (IGE) and the risk factors associated with them. We also studied the seizure outcome in patients with IGEs. Methods In this retrospective study, all patients with a diagnosis of IGE were recruited at the epilepsy clinic at Shiraz University of Medical Sciences, from 2008 through 2019. Age, gender, age at seizure onset, seizure type(s), EEG findings, and seizure outcome of all patients were registered. Results A total of 601 patients with IGE were studied; 516 patients (86%) had GTCSs. The ROC curve showed that reporting GTCSs was significantly associated with the time since the start of the disease ( P  = .0001; area under the curve = 0.71 [95% CI: 0.66‐0.76]; a cutoff point of 4 years [sensitivity = 61% and specificity = 76%]). Age at onset was 3.3 years later in patients with GTCSs compared with that in patients without GTCSs. Generalized spike‐wave complexes during interictal EEG recording were more frequently observed among patients without GTCSs. Generalized tonic‐clonic seizures were significantly associated with experiencing seizure‐related injuries. Valproate reduced the risk of experiencing GTCSs significantly (OR: 0.58; 95% CI: 0.34‐0.99; P  = .04). Conclusion Generalized tonic‐clonic seizures do not affect the seizure outcome in patients with IGEs per se, but how we manage them significantly affects the seizure outcome in these patients. Failure to prescribe valproate for women with IGE, particularly when another first‐line treatment has failed, may not be in a patient's best interests.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here