Childhood Absence Epilepsy
Conditions
Interventions
Absence
Children
Cognitive
Epilepsy
Sponsors
Medisch Universitair Ziekenhuis Maastricht
Eligibility
Age
2 Years to 17 Years
Inclusion criteria
Inclusion criteria: 1. Primarily presented with daily occurring episodes of brief loss of consciousness (absences) in an otherwise normal child in the previous 2 years. 2. An EEG showing 3 Hz (2.5-4.5 Hz) generalized rythmic spike-and-wave complexes with a discharge duration of at least 3 seconds on a present or former EEG. 3. Early absence epilepsy , defined as a confirmed diagnosis or seizures within 2 years. 4. Aged 6-12 years at inclusion 5. Permitted accompanying factors: - A few generalized tonic-clonic seizures (assessed individually according to ILAE statements); - Mild myoclonic eye(lid) movements - Co-morbidities: Attention deficiency/concentration disorders, autism, dyslexia and anxiety. These do not form exclusion criteria as this is frequently seen in children with absence seizures and it might be uncertain if the co-morbidity is a manifestation of the absence epilepsy., Age-gender matched controls - Overall healthy (do not have any of the exclusion criteria) and following a regular school without major problems, which makes a normal intelligence likely. - Aged 6-12 years on inclusion
Exclusion criteria
Exclusion criteria: * A diagnosis according to ILAE criteria of the following epilepsy syndromes: Juvenile Absence Epilepsy; Eylide myoclonia with absences; Dravet syndrome; Epilepsy with myoclonic-atonic seizures; Epilepsy with Myoclonic Absences; Lennox-Gastaut syndrome; Frontal Lobe Epilepsy or other focal epilepsy. * A confirmed diagnosis of epilepsy/seizures for more than 2 years (58). * Recent hospitalizations in the last months or a history which might limit participation in or completion of the study protocol. * Behavioural characteristics which might hamper the gathering of useful MRI data. * Intellectual disability or other diseases/causes that may underlie cognitive impairment (i.e. neurodegenerative diseases). * History of major head trauma or head/brain surgery. * MRI lesions on (previous) structural brain MRI- or CT-scans or symptomatic epilepsies (e.g. epilepsy related to tumours, vascular abnormalities, congenital dysgenesia). * MRI contra-indications: claustrophobia, anxiety for an MRI scan, or presence of metallic objects (e.g. prostheses, pacemakers, metal clips on blood vessels, metal parts in the eye). Dental braces are no exclusion criterion for absence patients. * Regularly using drugs of abuse (asked during screening session). * Parents or participants (aged*12 years) not willing to provide informed consent. * Parents or participants (aged*12 years) who do not want to get informed whenever structural abnormalities are found during imaging.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The main study parameters are: 1. Functional MRI parameters. 2. Neuropsychological parameters for neurocognitive development and behaviour, i.e. cognitive capacities, language, memory, visual (spatial) & motoric skills, attention/concentration, academic skills and behaviour. 3. Clinical characteristics (a priori defined characteristics are listed in form C1, page 25): i. Seizure semiology ii. Seizure control. iii. 24h-video-EEG (including standard hyperventilation and photic stimulation test) characteristics (frequency, type and localisation of diurnal and nocturnal epileptiform EEG discharges). 4. Educational development, educational delay (discrepancy score), results of the *Leerling Volgsysteem* (i.e. CITO score). 5. General behavioural (by proxy) assessment using a set of questionnaires. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary study parameters are: 1. Multimodal MRI parameters (structural, DTI and IVIM). 2. Demographic characteristics: age, gender, ethnicity, handedness, height, weight, regular teaching. 3. Other epilepsy related factors and other clinical parameters: age at onset, seizure semiology, seizure types, time between seizure onset and start AED treatment, seizure frequency before start AED, response to first AED, response to second AED etc., duration in years of seizures corrected for years in which seizures were controlled, type and dose of medication per kg, medical history. | — |
Countries
The Netherlands
Outcome results
None listed