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A reappraisal of atypical absence seizures in children and adults: therapeutic implications.
Expert Opin Pharmacother 2019; 20(17):2115-2120EO

Abstract

Introduction: Atypical absences are generalized epileptic seizures typically affecting children with severe epilepsies and learning difficulties along with other seizure types. Video-EEG is essential for their diagnosis. Recently, atypical absence seizures have been reported as a hallmark of some developmental and epileptic encephalopathies.Areas covered: This is a narrative review of the literature which describes the electroclinical features of atypical seizures, the characteristics of developmental epileptic encephalopathies in which this seizure type can occur, and the evidence supporting the use of individual antiseizure drugs for the treatment of atypical absences.Expert opinion: Treatment of absence seizures typically relies on ethosuximide (ineffective against tonic-clonic seizures), valproate (associated with larger proportion of adverse events), or lamotrigine (less effective than the other two). However, unlike typical absences, atypical absences are usually intractable, persist lifetime, and their prognosis depends on the underlying etiology or associated epilepsy syndrome. Besides efficacy, other relevant factors, such as drug formulation, ease of titration and dosing, and drug interactions, should be considered. Drugs that may worsen epilepsy, cognition and behavior should be avoided. In the vast majority of patients, a polytherapy is required, although usually with limited efficacy. Finally, epilepsy syndromes featuring atypical absences require a multidisciplinary approach.

Authors+Show Affiliations

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy. Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.Pediatric Neurology and Muscular Diseases Unit, DINOGMI-Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa, "G. Gaslini" Institute, Genova, Italy.Neurology Unit, S. Anna Hospital, Como, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31446808

Citation

Brigo, Francesco, et al. "A Reappraisal of Atypical Absence Seizures in Children and Adults: Therapeutic Implications." Expert Opinion On Pharmacotherapy, vol. 20, no. 17, 2019, pp. 2115-2120.
Brigo F, Striano P, Belcastro V. A reappraisal of atypical absence seizures in children and adults: therapeutic implications. Expert Opin Pharmacother. 2019;20(17):2115-2120.
Brigo, F., Striano, P., & Belcastro, V. (2019). A reappraisal of atypical absence seizures in children and adults: therapeutic implications. Expert Opinion On Pharmacotherapy, 20(17), pp. 2115-2120. doi:10.1080/14656566.2019.1656716.
Brigo F, Striano P, Belcastro V. A Reappraisal of Atypical Absence Seizures in Children and Adults: Therapeutic Implications. Expert Opin Pharmacother. 2019;20(17):2115-2120. PubMed PMID: 31446808.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A reappraisal of atypical absence seizures in children and adults: therapeutic implications. AU - Brigo,Francesco, AU - Striano,Pasquale, AU - Belcastro,Vicenzo, Y1 - 2019/08/24/ PY - 2019/8/27/pubmed PY - 2019/8/27/medline PY - 2019/8/27/entrez KW - Atypical absence seizures KW - epilepsy KW - epileptic syndromes KW - lennox-gastaut syndromes SP - 2115 EP - 2120 JF - Expert opinion on pharmacotherapy JO - Expert Opin Pharmacother VL - 20 IS - 17 N2 - Introduction: Atypical absences are generalized epileptic seizures typically affecting children with severe epilepsies and learning difficulties along with other seizure types. Video-EEG is essential for their diagnosis. Recently, atypical absence seizures have been reported as a hallmark of some developmental and epileptic encephalopathies.Areas covered: This is a narrative review of the literature which describes the electroclinical features of atypical seizures, the characteristics of developmental epileptic encephalopathies in which this seizure type can occur, and the evidence supporting the use of individual antiseizure drugs for the treatment of atypical absences.Expert opinion: Treatment of absence seizures typically relies on ethosuximide (ineffective against tonic-clonic seizures), valproate (associated with larger proportion of adverse events), or lamotrigine (less effective than the other two). However, unlike typical absences, atypical absences are usually intractable, persist lifetime, and their prognosis depends on the underlying etiology or associated epilepsy syndrome. Besides efficacy, other relevant factors, such as drug formulation, ease of titration and dosing, and drug interactions, should be considered. Drugs that may worsen epilepsy, cognition and behavior should be avoided. In the vast majority of patients, a polytherapy is required, although usually with limited efficacy. Finally, epilepsy syndromes featuring atypical absences require a multidisciplinary approach. SN - 1744-7666 UR - https://www.unboundmedicine.com/medline/citation/31446808/A_reappraisal_of_atypical_absence_seizures_in_children_and_adults:_therapeutic_implications L2 - http://www.tandfonline.com/doi/full/10.1080/14656566.2019.1656716 DB - PRIME DP - Unbound Medicine ER -