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Clinical and Video-Electroencephalogram Features of Childhood Absence Epilepsy and Its Diagnostic Criteria Investigation

MA Xiu-wei,ZHANG Yue-hua,YANG Zhi-xian,LIU Xiao-yan,SUN Hui-hui,JIANG Yu-wu,QIN Jiong,WU Xi-ru (Department of Pediatrics,Peking University First Hospital,Beijing 100034,China)  
Objective To analyze the clinical and video-electroencephalogram(VEEG) features of childhood absence epilepsy(CAE) and to discuss the diagnostic criteria for CAE.Methods The VEEG database were searched by using "absence seizures" and "3 Hz genera-lized spike and slow waves" as and excluded other epilepsy syndromes with typical absence seizures.Children who fulfilled the CAE diagnostic criteria of International League Against Epilepsy(ILAE) in 1989 were further evaluated with the diagnostic criteria proposed by Pana-yiotopoulos in 2005.Results There were 37 children fulfilled the diagnostic criteria for CAE of ILAE in 1989.The onset age of absence seizures ranged from 3 to 11 years.All cases had frequent absence seizures(5-60 times per day).Two cases(5.4%) had generalized tonic-clonic seizures.Hyperventilation induced absences in all children.VEEG confirmed that 9 cases(18.9%) had only simple absences and 25 cases(67.6%) had only complex absences,5 cases(13.5%) had both simple absences and complex absences.Ictal EEG showed 3 Hz generalized spike and wave(GSW) discharges in all children.The seizure duration ranged from 3 to 40 s.Four cases(10.8%) had two spikes per wave in ictal EEG.GSW fragments were found in 29 cases(78.4%) during sleep.Interictal polyspike and waves were present in 17 cases(45.9%).Focal discharges predominantly in the anterior regions were found in 22 cases(56.8%).Only 7 cases fulfilled the diagnostic criteria proposed by Panayiotopoulos in 2005.Conclusions Children who fulfilled the diagnostic criteria for CAE proposed by ILAE in 1989,few of them met the new diagnostic criteria proposed by Panayiotopoulos in 2005.The new stricter criteria for CAE resulted in some children unclassified.
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