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Severe myoclonic epilepsy in infancy: A systematic review and a meta‐analysis of individual patient data
Author(s) -
Kassaï Behrouz,
Chiron Catherine,
Augier Ségolène,
Cucherat Michel,
Rey Elisabeth,
Gueyffier François,
Guerrini Renzo,
Vincent Julien,
Dulac Olivier,
Pons Gérard
Publication year - 2008
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2007.01423.x
Subject(s) - medicine , odds ratio , meta analysis , randomized controlled trial , myoclonic epilepsy , placebo , pediatrics , epilepsy , medline , psychiatry , alternative medicine , pathology , political science , law
SummarySevere myoclonic epilepsy in infancy (SMEI) is a rare, but severe disorder with seizures typically resistant to conventional antiepileptic drugs. The objective of the present study was to systematically review the literature on the available treatments for SMEI.Databases searched included Medline, Embase, and Cochrane. We used a fixed effect model to summarize the odds ratio of seizures rates and a logistic model to evaluate the influence of patient characteristics on treatment effect.We found 23 uncontrolled studies and 2 randomized controlled trials (RCTs) that compared stiripentol with placebo. Overall, 64 children aged between 3 and 20 years were included in the two RCTs. The odds ratio of responding to stiripentol relative to placebo was 32 (CI: 6.2, 161) and stiripentol reduced seizure rate by 70% (93%; 47%). The multivariate analysis does not suggest any differences within subgroups of participants and cotherapy.Results of uncontrolled studies in children with SMEI are potentially biased and do not provide valid information on the benefits and harms of treatments. The two RCTs identified, however, were performed with the same objectives and design and showed that seizure frequency is greatly reduced by stiripentol in children with SMEI after 2 months of treatment.