P172 Postictal mental abnormalities – differences between primary, secondarily generalized and complex partial seizures

P172 Postictal mental abnormalities – differences between primary, secondarily generalized and complex partial seizures

Posters P171 Long term efficacy of valproate versus lamotrigine in treatment of idiopathic generalized epilepsies M. Mazurkiewicz-Beldzinska1 *, M. Szm...

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Posters P171 Long term efficacy of valproate versus lamotrigine in treatment of idiopathic generalized epilepsies M. Mazurkiewicz-Beldzinska1 *, M. Szmuda1 , A. Matheisel1 . 1 Department of Developmental Neurology, Medical University of Gdansk, Poland In order to estimate and compare the long-term effectiveness of lamotrigine (LTG) versus valproate (VPA) monotherapy in treatment of idiopathic generalized epilepsies (IGE) the following study was performed. Method: Medical records of 214 children and adolescents suffering from IGE were analyzed. 132 of them were on VPA monotherapy, 82 on LTG. The majority of patients had juvenile myoclonic epilepsy − 98, juvenile absence epilepsy − 32, childhood absence epilepsy − 53 and epilepsy with a tonic-clonic seizures on awakening − 12, others − 19. Mean age of the patients was 8.9 years (range 4−16 years). The mean time of treatment was 28 months, time of observation 40 months. In order to estimate retention rates and factors predicting successful treatment with LTG and VPA we used Kapplan-Meyer analysis and Gehan tests. Results: Data analysis showed significantly longer retention rates with VPA versus LTG treatment in overall rates as well in all syndromes subgroups. After 12 months of therapy 69% stayed on LTG therapy versus 89% on VPA, after 24 months 57% vs 83% respectively. VPA showed comparable efficacy in all IGE syndromes where LTG showed better efficacy in childhood and juvenile absence epilepsy than in juvenile myoclonic epilepsy. The shorter duration of treatment with LTG was due to lack of efficacy. Conclusions: Our results show the superiority of VPA vs LTG treatment in idiopathic generalized epilepsy syndromes. P172 Postictal mental abnormalities − differences between primary, secondarily generalized and complex partial seizures M. Szmuda1 *, M. Mazurkiewicz-Beldzinska1 . 1 Department of Developmental Neurology, Medical University of Gdansk, Poland Introduction: The study was performed in order to assess the frequency and course of postictal mental symptoms/abnormalities in groups of patients (1) primarily, (2) secondarily generalized seizures and (3) complex partial seizures as well as to indicate which group of patients is predisposed to delayed resumption of baseline central nervous function. Material and Methods: The study was conducted at the Department of Developmental Neurology of Medical University Hospital in Gdansk between 2006 and 2007. 200 children after epileptic seizure, aged from 1 to 17 years, were retrospectively evaluated. Results: There were 169 patients with partial (complex and secondarily generalized) seizures (PS) and 31 patients with primarily generalized seizures (PGS). Postictal mental disturbances were observed in 126 (74.5%) patients. In this group, drowsiness occurred in 18 (14%) patients, postictal sleep − 67 (53%), coma − 1 (1%) amnesia − 12 (9.5%), confusion − 9 (7%), disorientation − 6 (5%), emotional disturbances − 8 (6%), movement disturbances − 5 (4%). Recovery time 1 h was more frequent in PS than in PGS. Conclusions: Mental disturbances are more frequent after PS. Patients after PS need more time to regain full consciousness. Further studies on aetiology of seizures with postictal mental abnormalities would be precious

S73 P173 A 10-year follow-up of well-functioning children with epilepsy from a population based study in a Swedish county P. Jonsson1 *, O. Eeg-Olofsson1 . 1 Department of Women’s and Children’s Health, Uppsala University, Sweden Objective: A population based study of epilepsy in children, 1 month to 16 years, from a Swedish county was published in 20061 . From this material of children born 1985 and later, well-functioning children treated for epilepsy 1997−01−01 were invited 10 years later to participate in a follow-up study in order to investigate how they had got along from medical, social and psychological aspects. This first part deals with the medical and social ones. Methods: A questionnaire was sent out twice to children and their families, and in some cases also a telephone interview was performed. The hospital records of all patients were reviewed. Results: The response rate was 96%. Fourty-nine children, 28 girls and 21 boys, aged 11−22 years (Md: 18.5) were evaluated. A syndrome classification included Rolandic epilepsy in 30%, CAE/JAE in 10%, Panayiotopoulos syndrome in 4%, and West syndrome in 4%. A family history of epilepsy was found in 41%, febrile seizures in 18% and migraineous headache in 59%. The patients had a history of febrile seizures in 18%, migraineous headache in 27%, and behaviour disorder in 14% (ADHD, Asperger syndrome and bipolar disorder). Active epilepsy at the follow-up was found in 24%. The most common AED was valproate. All participants were in or had attended comprehensive school, most of them were in or had finished high school, and a few studied at university. Fulltime employment was reported by 20%. Conclusions: In this group of well-functioning children, the prevalence of Rolandic epilepsy is high, as expected. There is also a high frequency of a history of febrile seizures and of migraineous headache in both families and patients. In a second part of this study, the results will be related to psychological outcome. Reference(s) [1] Larsson K, Eeg-Olofsson O. Eur J Paediatr Neurol 2006;10:107−13.

P174 Evolution of electrographic characteristics and correlation with clinical changes in children on a ketogenic diet K. Verhaert1,2 *, S. Boyd2 , E.G. Neal1,2 , H. Chaffe1,2 , R.H. Schwartz3 , M.S. Lawson2 , N. Edwards2 , G. Fitzsimmons2 , A. Whitney2 , J.H. Cross1,2 . 1 UCL-Institute of Child Health, London, UK; 2 Great Ormond Street Hospital for Children NHS Trust, London, UK; 3 Central Middlesex Hospital, London, UK Background: The ketogenic diet (KD) has been demonstrated to be effective in reducing seizures in children with drug resistant epilepsy. The aim of this study was to review EEG changes in children treated with the KD and correlate these with clinical outcome. Methods: This study was part of a larger RCT, where of 94 children who continued the diet for minimum 3 mo, 45 continued for 12 months. Clinical, biochemical and EEG review were carried out at baseline, 3, 6 and 12 months. Assessment of seizure frequency was by seizure charts. In a pilot study, EEGs were scored on a semi-quantitative scale for amount of interictal epileptic discharges (IED) and degree of abnormality of ongoing activity (OA) by an experienced electro-encephalographer who was blinded to clinical information and time-point of investigation. This was compared to behavioral data, gathered from standardized questionnaires and Revised Conners’ Rating Scales. Results: EEGs of 10/45 of the children were reviewed. IEDs at 12 months had improved in seven, worsened in one and showed no change in two of ten children. They fluctuated