Objective Eyelid myoclonia with absences (EMA) is a syndrome characterized by eyelid myoclonia with or without absences, eye closure‐induced generalized electroencephalographic (EEG) paroxysms and photosensitivity. Few data are available about the prognostic factors of this syndrome. The main objectives of our study were to describe the clinical and EEG features of a group of patients with EMA and to evaluate the presence of prognostic factors. Methods We retrospectively selected a cohort of patients with diagnosis of EMA evaluated in the epilepsy service of the Neurological Clinic of Catania, in the Neurology and Clinical Neurophysiopathology Unit of Oasi Research Institute, Troina and in the Regional Epilepsy Centre of Bianchi‐Melacrino‐Morelli Hospital of Reggio Calabria. We considered the features of the patients during the first year of disease, and at the last follow‐up visit. We stratified the patients into two groups: “seizure‐free”, defined as the absence of seizures for at least 2 years, and “not seizure‐free” and we evaluated the evolution of their characteristics and the presence of factors associated with outcome. Results We enrolled 51 patients (40 women (78%); mean age: 30.8 years ± 15.5 [range 10‐79]). The mean follow‐up time was 8.7 ± 5.8 years. Eleven patients (21.6%) achieved the condition of seizure‐free. Family history of epilepsy was associated with the condition of seizure‐free (P = 0.05). At the last follow‐up visit, EEG photosensitivity and eye closure sensitivity were significantly associated with the condition of “not seizure‐free”. Significance The results of our study revealed that a positive family history of epilepsy might be associated with a better outcome in EMA. Furthermore, the persistence of photosensitivity and eye closure sensitivity might indicate persistence of seizures, offering an aid in therapeutic management.

A B S T R A C TPurpose: To estimate the incidence of ictal hypoxemia (IH) and to identify clinical and study-related factors modulating the estimate. Methods: We searched articles recording concurrent peri-ictal and ictal EEG and Sp02 in adults and children with epilepsy. Studies reporting the total number of seizures recorded and the number of seizures with IH were included in a random-effects meta-analysis. A random-effects meta-regression was used to identify variables affecting study heterogeneity. Results: Twenty-one studies, including 917 participants and 1840 with SpO2 data available were included. The meta-analysis showed a pooled incidence of IH of 35/100 seizures (95% CI 27-44). Sp02 desaturation threshold was associated with the incidence of IH, with less severe desaturations resulting in higher IH frequencies. The incidence of IH was 41/100 seizures (95% CI 29-54) for adults and 47/100 seizures (95% CI 15-78) for tonicclonic seizures. The meta-regression showed that SpO2 desaturation severity was the sole variable significantly correlated with the incidence of ictal hypoxemia (p = 0.00). Conclusion: In a population with refractory epilepsy IH is a frequent phenomenon, especially in adults and in patients presenting with tonic-clonic seizures. The severity of IH appeared independent from the age group and from seizure type and is probably the major clinical concern for its correlation with potentially life-threatening cardiorespiratory alterations and sudden unexpected death in epilepsy (SUDEP). factors on its occurrence, severity, duration and association with apnea https://doi.

The maintenance of seizure control over time is a clinical priority in patients with epilepsy. The aim of this study was to assess the sustained seizure frequency reduction with adjunctive brivaracetam (BRV) in real‐world practice. Patients with focal epilepsy prescribed add‐on BRV were identified. Study outcomes included sustained seizure freedom and sustained seizure response, defined as a 100% and a ≥50% reduction in baseline seizure frequency that continued without interruption and without BRV withdrawal through the 12‐month follow‐up. Nine hundred ninety‐four patients with a median age of 45 (interquartile range = 32–56) years were included. During the 1‐year study period, sustained seizure freedom was achieved by 142 (14.3%) patients, of whom 72 (50.7%) were seizure‐free from Day 1 of BRV treatment. Sustained seizure freedom was maintained for ≥6, ≥9, and 12 months by 14.3%, 11.9%, and 7.2% of patients from the study cohort. Sustained seizure response was reached by 383 (38.5%) patients; 236 of 383 (61.6%) achieved sustained ≥50% reduction in seizure frequency by Day 1, 94 of 383 (24.5%) by Month 4, and 53 of 383 (13.8%) by Month 7 up to Month 12. Adjunctive BRV was associated with sustained seizure frequency reduction from the first day of treatment in a subset of patients with uncontrolled focal epilepsy.

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