Epidemiology and outcome of idiopathic generalized epilepsy in adults

Abstract

Background and purpose Drug‐resistant idiopathic generalized epilepsy (IGE) remains challenging despite a favourable overall prognosis of IGE, and little is known about basic epidemiology and long‐term outcome of drug‐resistant IGE. The aim of the study was to describe the incidence, prevalence and outcome of IGE in an unbiased, population‐based cohort. Methods In 2014–2018, all patients (≥17 years) with IGE inhabiting the island of Funen (496 000 inhabitants) were recruited. The socioeconomic and clinical information available for 406 individuals was assessed. Median follow‐up was 15 years. Results The average IGE incidence (2008–2017) was 2.9/100 000 inhabitants/year. The point prevalence of identifiable IGE patients was 1.0/1000 adults (juvenile myoclonic epilepsy 0.4/1000; absence epilepsy 0.3/1000, epilepsy with generalized tonic–clonic seizures alone 0.3/1000); 92.1% of the patients were diagnosed before 25 years of age. When correcting for unequal age distribution in the cohort, 1102 people on the island of Funen fulfilled the diagnostic criteria for IGE at the age of 25 (estimated prevalence 2.7/1000 adults). In the year before data closure, 121 patients reported seizures. Fifty patients met the definition of drug‐resistant IGE (12.1% of the cohort, 4.5% of the estimated 1102 IGE patients). The average seizure burden of all patients with drug‐resistant IGE was 2.2 generalized tonic–clonic seizures per year; only 14 patients suffered more than two generalized tonic–clonic seizures per year. Drug‐resistant IGE was associated with an increased risk of requiring treatment for affective disorders and a reduced probability of working full time. Conclusion Idiopathic generalized epilepsy was associated with a low risk of persistent drug‐resistant seizures requiring specialist medical attention. Drug resistance was associated with a negative socioeconomic outcome.

Synthesis, docking study, and pharmacological evaluation of S-acetamide derivatives of 4,6-dimethyl-2-thiopyrimidine as anticonvulsant agents

“…In developed countries, from 1 to 18 new cases of the disease per 1,000 people are annually registered, and in developing countries to 30 cases (Johnson, 2019;Vogt et al, 2017). Despite the large number of works on epilepsy pharmacotherapy, a relatively wide range of antiepileptic drugs (AEDs) with different mechanisms of action, including prolonged action, and satisfactory control of seizures is only achieved in 65%-70% of patients (Gesche et al, 2019). In some patients, AEDs cause an increase in the frequency of attacks and the appearance of a large number of side effects, the transformation of attacks, and the deterioration of encephalographic indicators (Janmohamed, 2020;Vossler et al, 2018).…”

The clinical spectrum of familial and sporadic idiopathic generalized epilepsy

“…Parts of the cohort and data collection (including in-and exclusion criteria) have been previously described (Gesche et al, 2019(Gesche et al, , 2017 In brief, adult patients (age ≥17 years at inclusion) with at least one primarily generalized seizure type (absence, generalized tonicclonic seizure, myoclonic seizure) in their history were included. EEG with generalized 3-6 Hz spike-wave activity in the EEG was required, unless the patient was <20 years old at first seizure AND had a normal MRI of the brain AND classical primarily generalized seizures allowing the clinical diagnosis of JAE, JME or EGTCS based on the clinical features alone (Panayiotopoulos, 2012).…”

“…Definition of drugs response or resistance was described in detail in (Gesche et al, 2019). In brief, drug resistance was defined as ≥1 seizure in the year preceding the latest clinical assessment despite adequate trials of two appropriately chosen and used antiepileptic schedules.…”

Assessment of higher mental functions in patients with idiopathic (genetic) generalized epilepsies

“…Fisher и соавт. [33]) сообщалось, что это наиболее распространенный когнитивный симптом у пациентов с эпилепсией. Вероятно, несоответствие связано с тем, что нарушения рабочей памяти переносятся хуже и более заметны, чем снижение в других когнитивных областях [34].…”