Evidence map›Paper›PMID 38588009›Full record

ArticleEpilepsia open2024

Epileptic spasms relapse is associated with response latency but not conventional attributes of post-treatment EEG.

Emmi Deckard, Rujuta Sathe, David Tabibzadeh, Aria Terango, Aran Groves, Rajsekar R Rajaraman, Hiroki Nariai, Shaun A Hussain

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Epilepsia open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Emmi DeckardDepartment of Pediatrics, Division of Neurology, University of California Los Angeles and UCLA Mattel Children's Hospital, California, Los Angeles, USA.
Rujuta SatheDepartment of Pediatrics, Division of Neurology, University of California Los Angeles and UCLA Mattel Children's Hospital, California, Los Angeles, USA.
David TabibzadehDepartment of Pediatrics, Division of Neurology, University of California Los Angeles and UCLA Mattel Children's Hospital, California, Los Angeles, USA.
Aria TerangoDepartment of Pediatrics, Division of Neurology, University of California Los Angeles and UCLA Mattel Children's Hospital, California, Los Angeles, USA.
Aran GrovesDepartment of Pediatrics, Division of Neurology, University of California Los Angeles and UCLA Mattel Children's Hospital, California, Los Angeles, USA.
Rajsekar R RajaramanDepartment of Pediatrics, Division of Neurology, University of California Los Angeles and UCLA Mattel Children's Hospital, California, Los Angeles, USA.
Hiroki NariaiDepartment of Pediatrics, Division of Neurology, University of California Los Angeles and UCLA Mattel Children's Hospital, California, Los Angeles, USA.ORCID https://orcid.org/0000-0002-8318-2924
Shaun A HussainDepartment of Pediatrics, Division of Neurology, University of California Los Angeles and UCLA Mattel Children's Hospital, California, Los Angeles, USA.ORCID https://orcid.org/0000-0001-6947-8852

Funding

John C. Hench Foundation
6 · The paper itself

Abstract

objectiveRelapse of epileptic spasms after initial treatment of infantile epileptic spasms syndrome (IESS) is common. However, past studies of small cohorts have inconsistently linked relapse risk to etiology, treatment modality, and EEG features upon response. Using a large single-center IESS cohort, we set out to quantify the risk of epileptic spasms relapse and identify specific risk factors.

methodsWe identified all children with epileptic spasms at our center using a clinical EEG database. Using the electronic medical record, we confirmed IESS syndrome classification and ascertained treatment, response, time to relapse, etiology, EEG features, and other demographic factors. Relapse-free survival analysis was carried out using Cox proportional hazards regression.

resultsAmong 599 children with IESS, 197 specifically responded to hormonal therapy and/or vigabatrin (as opposed to surgery or other second-line treatments). In this study, 41 (21%) subjects exhibited relapse of epileptic spasms within 12 months of response. Longer duration of IESS prior to response (>3 months) was strongly associated with shorter latency to relapse (hazard ratio = 3.11; 95% CI 1.59-6.10; p = 0.001). Relapse was not associated with etiology, developmental status, or any post-treatment EEG feature. SIGNIFICANCE: This study suggests that long duration of IESS before response is the single largest clinical predictor of relapse risk, and therefore underscores the importance of prompt and successful initial treatment. Further study is needed to evaluate candidate biomarkers of epileptic spasms relapse and identify treatments to mitigate this risk. PLAIN LANGUAGE SUMMARY: Relapse of infantile spasms is common after initially successful treatment. With study of a large group of children with infantile spasms, we determined that relapse is linked to long duration of infantile spasms. In contrast, relapse was not associated with the cause of infantile spasms, developmental measures, or EEG features at the time of initial response. Further study is needed to identify tools to predict impending relapse of infantile spasms.

Indexed as

AnticonvulsantsElectroencephalographyRecurrenceSpasms, InfantileChild, PreschoolCohort StudiesFemaleHumansInfantMaleRisk FactorsTreatment OutcomeVigabatrinAnticonvulsantsVigabatrinepileptiform dischargesinfantile spasmsvigabatrinwest syndrome

Identifiers

PMID38588009
PMCPMC11145600

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.