Original article
Idiopathic generalized epilepsies: Analysis of 101 patients
Epilepsias generalizadas idiopáticas: análisis de 101 pacientes
Maria Magdalena Rosselló Vadell
, Ana Belén Martínez García, Maria Inès Barceló Artigues, Antonio José Moreno Rojas
Corresponding author
Servicio de Neurología, Hospital Universitario Son Espases, Palma de Mallorca, Balearic Islands, Spain
Read
12
Timeswas read the article
3
Total PDF
9
Total HTML
Share statistics
array:24 [ "pii" => "S2387020623000505" "issn" => "23870206" "doi" => "10.1016/j.medcle.2022.06.020" "estado" => "S300" "fechaPublicacion" => "2023-03-10" "aid" => "6046" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2022" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Med Clin. 2023;160:193-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0025775322004092" "issn" => "00257753" "doi" => "10.1016/j.medcli.2022.06.019" "estado" => "S300" "fechaPublicacion" => "2023-03-10" "aid" => "6046" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Med Clin. 2023;160:193-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Epilepsias generalizadas idiopáticas: análisis de 101 pacientes" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "193" "paginaFinal" => "198" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Idiopathic generalized epilepsies: Analysis of 101 patients" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Maria Magdalena Rosselló Vadell, Ana Belén Martínez García, Maria Inès Barceló Artigues, Antonio José Moreno Rojas" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Maria Magdalena" "apellidos" => "Rosselló Vadell" ] 1 => array:2 [ "nombre" => "Ana Belén" "apellidos" => "Martínez García" ] 2 => array:2 [ "nombre" => "Maria Inès" "apellidos" => "Barceló Artigues" ] 3 => array:2 [ "nombre" => "Antonio José" "apellidos" => "Moreno Rojas" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020623000505" "doi" => "10.1016/j.medcle.2022.06.020" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623000505?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775322004092?idApp=UINPBA00004N" "url" => "/00257753/0000016000000005/v3_202304070253/S0025775322004092/v3_202304070253/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020623000517" "issn" => "23870206" "doi" => "10.1016/j.medcle.2022.07.024" "estado" => "S300" "fechaPublicacion" => "2023-03-10" "aid" => "6052" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2023;160:199-202" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Brief report</span>" "titulo" => "Cytomegalovirus disease in immunosuppressed patients with necrotizing pauci-immune glomerulonephritis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "199" "paginaFinal" => "202" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Enfermedad por citomegalovirus en los pacientes inmunodeprimidos por glomerulonefritis necrosante pauciinmune" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sergio Barroso Hernández, Jorge Alberto Rodríguez Sabillón, Álvaro Álvarez López, Elena García de Vinuesa Calvo, Antonia Calvo Cano, Nicolás Roberto Robles Pérez-Monteoliva" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Sergio" "apellidos" => "Barroso Hernández" ] 1 => array:2 [ "nombre" => "Jorge Alberto" "apellidos" => "Rodríguez Sabillón" ] 2 => array:2 [ "nombre" => "Álvaro" "apellidos" => "Álvarez López" ] 3 => array:2 [ "nombre" => "Elena" "apellidos" => "García de Vinuesa Calvo" ] 4 => array:2 [ "nombre" => "Antonia" "apellidos" => "Calvo Cano" ] 5 => array:2 [ "nombre" => "Nicolás Roberto" "apellidos" => "Robles Pérez-Monteoliva" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775322004158" "doi" => "10.1016/j.medcli.2022.07.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775322004158?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623000517?idApp=UINPBA00004N" "url" => "/23870206/0000016000000005/v1_202303052139/S2387020623000517/v1_202303052139/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2387020623000591" "issn" => "23870206" "doi" => "10.1016/j.medcle.2022.06.021" "estado" => "S300" "fechaPublicacion" => "2023-03-10" "aid" => "6047" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Med Clin. 2023;160:187-92" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "COVID-19 and its implications on the clinico-radiological course of multiple sclerosis: A case–control study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "187" "paginaFinal" => "192" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "COVID-19 y sus implicaciones en el curso clínico-radiológico de la esclerosis múltiple: un estudio de casos y controles" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Mohammad Rahmani, Abdorreza Naser Moghadasi, Shayan Shahi, Sharareh Eskandarieh, Hossein Azizi, Alireza Hasanzadeh, Ali Ahmadzade, Ali Zare Dehnavi, Ramin Hamidi Farahani, Mohammad Aminianfar, Alireza Ranjbar Naeini" "autores" => array:11 [ 0 => array:2 [ "nombre" => "Mohammad" "apellidos" => "Rahmani" ] 1 => array:2 [ "nombre" => "Abdorreza Naser" "apellidos" => "Moghadasi" ] 2 => array:2 [ "nombre" => "Shayan" "apellidos" => "Shahi" ] 3 => array:2 [ "nombre" => "Sharareh" "apellidos" => "Eskandarieh" ] 4 => array:2 [ "nombre" => "Hossein" "apellidos" => "Azizi" ] 5 => array:2 [ "nombre" => "Alireza" "apellidos" => "Hasanzadeh" ] 6 => array:2 [ "nombre" => "Ali" "apellidos" => "Ahmadzade" ] 7 => array:2 [ "nombre" => "Ali Zare" "apellidos" => "Dehnavi" ] 8 => array:2 [ "nombre" => "Ramin Hamidi" "apellidos" => "Farahani" ] 9 => array:2 [ "nombre" => "Mohammad" "apellidos" => "Aminianfar" ] 10 => array:2 [ "nombre" => "Alireza Ranjbar" "apellidos" => "Naeini" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623000591?idApp=UINPBA00004N" "url" => "/23870206/0000016000000005/v1_202303052139/S2387020623000591/v1_202303052139/en/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Idiopathic generalized epilepsies: Analysis of 101 patients" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "193" "paginaFinal" => "198" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Maria Magdalena Rosselló Vadell, Ana Belén Martínez García, Maria Inès Barceló Artigues, Antonio José Moreno Rojas" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Maria Magdalena" "apellidos" => "Rosselló Vadell" "email" => array:1 [ 0 => "mm.rossello.vadell@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Ana Belén" "apellidos" => "Martínez García" ] 2 => array:2 [ "nombre" => "Maria Inès" "apellidos" => "Barceló Artigues" ] 3 => array:2 [ "nombre" => "Antonio José" "apellidos" => "Moreno Rojas" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neurología, Hospital Universitario Son Espases, Palma de Mallorca, Balearic Islands, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Epilepsias generalizadas idiopáticas: análisis de 101 pacientes" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Idiopathic generalised epilepsies (IGEs) are an electroclinical syndrome of genetic origin, with a specific age of onset and a characteristic electroencephalographic pattern.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> According to the latest ILAE 2017 classification, four syndromes are included under the term IGE: childhood absence epilepsy (CAE), juvenile absence epilepsy (JAE), juvenile myoclonic epilepsy (JME) and epilepsy with generalised tonic-clonic seizures (EGTCS).<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> They differ mainly in the age of seizure onset and the predominant seizure subtype, although it is possible that they could be part of a neurobiological continuum.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Several studies point to a better prognosis of IGE compared to other types of epilepsy, although studies referring to the long-term prognosis of this group of patients are relatively scarce and comparison is difficult given the heterogeneity between studies, especially in methodology and diagnostic criteria used.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Despite the heterogeneity between the studies, the long-term prognosis seems to differ between the different syndromes. JME is possibly the most studied group given that it is the one with the largest number of patients in the series described.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5–11</span></a> The general perception is that seizure control is achieved in a high percentage of patients with adequate treatment and that "pseudoresistance" is due to lifestyle and poor treatment compliance. In general, highly variable remission rates have been reported, ranging from 29 to 86% at 5 years,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> although some more recent studies have reported somewhat more homogeneous remission rates, with a remission rate of around 59% at 5 years when analysing prognosis over a longer time course of epilepsy.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> In terms of treatment, it has generally been assumed that JME patients need anti-seizure treatment for life, and that withdrawal is not a valid option given the high risk of relapse, although several studies describe a non-negligible percentage of patients who remain seizure-free and without anti-seizure treatment.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14–18</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">With regard to absence epilepsies, CAE appears to have the highest percentage of remission using strict diagnostic criteria such as those of De Hirsch & Panayiotopoulos 2005, whereas using less stringent criteria such as those of the ILAE 1989, this percentage is lower.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The long-term prognosis of JAE also appears to be somewhat worse, with lower remission rates and higher recurrence rates after anti-seizure treatment withdrawal.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12–19</span></a> Studies that refer to EGTCS are scarcer.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13–20</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The objective of this study is to describe the clinical characteristics of our IGE patients, to analyse the pharmacological treatment and long-term prognosis, as well as the withdrawal of anti-seizure treatment and the recurrence of seizures, and to see if there are differences between the different syndromes.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">We have designed an observational and retrospective study with a cross-sectional design carried out in a tertiary hospital where around 1,300 patients with epilepsy are seen each year. We analysed variables from the medical records of patients diagnosed with IGE from the epilepsy unit database between 2008 and 2020.</p><p id="par0035" class="elsevierStylePara elsevierViewall">This study has been approved by the Research Ethics Committee of our autonomous community. No informed consent was required from the patients as this was a retrospective study with analysis of anonymised variables.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Inclusion criteria</span><p id="par0265" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1</span><p id="par0040" class="elsevierStylePara elsevierViewall">Diagnosis of one of the 4 IGE syndromes (CAE, JAE, JME and EGTCS), based on the ILAE 1989 criteria.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2</span><p id="par0045" class="elsevierStylePara elsevierViewall">Follow-up period of at least one year.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3</span><p id="par0050" class="elsevierStylePara elsevierViewall">The minimum age is 15, the age at which the transition to adult neurology from paediatrics takes place.</p></li></ul></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Exclusion criteria</span><p id="par0270" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">1</span><p id="par0055" class="elsevierStylePara elsevierViewall">Non-classifiable syndromes and other GGE syndromes (myoclonic absence epilepsy, Jeavons syndrome, childhood myoclonic epilepsy, etc.).</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">2</span><p id="par0060" class="elsevierStylePara elsevierViewall">Doubts about the diagnosis.</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">3</span><p id="par0065" class="elsevierStylePara elsevierViewall">Patients in whom the EEG study could not be completed, or the EEG did not show the presence of generalised epileptiform abnormalities.</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">4</span><p id="par0070" class="elsevierStylePara elsevierViewall">Psychomotor retardation.</p></li></ul></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Variables</span><p id="par0075" class="elsevierStylePara elsevierViewall">Epidemiological variables were collected: sex, current age, age at seizure onset, seizure type, family history of epilepsy (up to third-degree relatives), psychiatric comorbidity (anxiety, depression, insomnia and ADHD) and history of status epilepticus. The time course of epilepsy (calculated as the time elapsed from the onset of seizures to the date of the last follow-up in outpatient clinics, expressed in years) as well as the current drug therapy and the need for combination therapy were also collected. Finally, terminal remission for all seizure types at 1 and 5 years, and remission of only generalised tonic-clonic seizures (GTCS) at 5 years (terminal remission being understood as freedom from seizures during the last year or the last 5 years since the last outpatient contact); discontinuation of drug therapy and relapse in case of withdrawal, as well as triggers for seizure recurrence were collected. Also the percentage of resolved epilepsies (according to the ILAE, resolved epilepsy is defined as patients who have been seizure-free for >10 years of which >5 years without drug therapy).</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0080" class="elsevierStylePara elsevierViewall">Statistical analysis was carried out with IBM SPSS® Statistics v22. The qualitative variables are expressed as a total number of cases and as a percentage (%) of the total. For quantitative variables, results are expressed as median and interquartile range. The Shapiro-Wilk test and the Kolmogorov-Smirnoff test were used to determine whether the variables follow a normal distribution. For comparisons between qualitative variables, Pearson's Chi-square test and Fisher's exact test were used. For comparisons between quantitative variables, the Mann–Whitney U test or the Kruskal–Wallis test was used. A value of p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05 was considered statistically significant. Finally, a binomial logistic regression analysis was used to detect the factors associated with freedom from seizures.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Patient characteristics</span><p id="par0085" class="elsevierStylePara elsevierViewall">A total of 101 patients were included. Of these, 57 (56.4%) were women. The median age at the time of analysis was 35 years (interquartile range: 25–43). The median age at last follow-up was 33 years (interquartile range: 23–42) and the median time course of epilepsy was 17 years (interquartile range: 7−31<span class="elsevierStyleHsp" style=""></span>years). The most common syndrome was JME (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>47; 46.5%), followed by EGTCS (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>26; 25.7%), JAE (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>14; 13.9%) and CAE (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>14; 13.9%).</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">The characteristics of each group are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a></span><p id="par0090" class="elsevierStylePara elsevierViewall">The age of seizure onset was different across the groups (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,000): JME (median: 15; interquartile range: 12−17); JAE (median: 12.5; interquartile range: 10−13); EGTCS (median: 18; interquartile range: 15−20), and CAE (median: 6.5; interquartile range: 4−7).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Overall, 30 patients (35.7%) had a family history of epilepsy, although in 17 (16.8%) patients we were unable to collect this information. Two patients (2%) had a history of status epilepticus, both absence status, in one patient with JAE and in another patient with CAE. Overall, 15.8% had psychiatric comorbidity.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Seizure type</span><p id="par0100" class="elsevierStylePara elsevierViewall">The type of seizures in each subgroup is summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Analysing the combination of seizures, the most common type in JME were patients with myoclonus and GTCS (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>34; 72.3%), followed by those who had all 3 types of seizures (myoclonus, GTCS and absences) (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8; n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8; 17%), only myoclonic seizures (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3; 6.4%) and myoclonic seizures and absences (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2; 4.3%).</p><p id="par0105" class="elsevierStylePara elsevierViewall">Regarding JAE, the most prevalent group were patients with absences and GTCS (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>10; 71.4%), followed by those with only absences (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2; 14.3%), the 3 types of seizures in one patient (7.1%) and absences and myoclonus in one patient (7.1%).</p><p id="par0110" class="elsevierStylePara elsevierViewall">As per CAE, the majority (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>11; 78.6%) had absences and GTCS, and 3 patients (21.4%) had only absences.</p><p id="par0115" class="elsevierStylePara elsevierViewall">All EGTCS patients (100%) only had GTCS.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Drugs</span><p id="par0120" class="elsevierStylePara elsevierViewall">Total 72.82% (n.<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>73) of the patients were on treatment with an anti-seizure drug, followed by 15.84% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>16) with 2 drugs and 3.96% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>4) with 3 drugs. 7.92% (n.<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8) did not take any drugs.</p><p id="par0125" class="elsevierStylePara elsevierViewall">With regard to the number of patients on combination therapy, we observed significant differences between the different syndromes (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.001). JME and EGTCS showed a higher percentage of monotherapy (78.7 and 84.6%, respectively) compared to combination therapy (17 and 3.8%, respectively). In contrast, more than half (57.1%) of the JAE patients were on combination therapy. 50% of CAE patients were on monotherapy, but the antiepileptic medication could be withdrawn in 21.4% of them. The total number and percentage of patients with monotherapy, combination therapy and no treatment in each of the syndromes is summarised in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">25.7% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>26) have been on dual therapy at some point in the course of their epilepsy, while the remaining 74.3% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>75) have always been on monotherapy.</p><p id="par0135" class="elsevierStylePara elsevierViewall">Regarding the use of anti-seizure drugs, overall, the most commonly used drug was valproic acid (VPA) in 37.9% of patients. In contrast, in women of childbearing age (under 50) it was levetiracetam (LEV) (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>15); followed by VPA (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>14) and lamotrigine (LTG) (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>12). On the other hand, among males of the same age (under 50) the most commonly used drug was VPA (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>26), followed by LTG (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8) and LEV (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>7). The use of anti-seizure drugs in each syndrome is summarized in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">The drugs most commonly used in combination were VPA in 9.9% of patients; followed by LTG in 8.9%; LEV in 6.9% and ethosuximide (ESM) in 5%. The most common combinations were VPA<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>LTG used in 4% of patients, followed by LEV<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>LTG in 2%; LTG<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>perampanel (PER) in 2% and PER<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>ESM in 2%. The rest of the combinations were different in each patient. We observed that patients who remained seizure-free at 5 years were on LEV<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>VPA and LEV<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>zonisamide (ZNS). With the most common combination (VPA<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>LTG), 75% of patients were not seizure-free at 5 years.</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Seizure freedom</span><p id="par0145" class="elsevierStylePara elsevierViewall">Overall, 73 patients (72.3%) had terminal seizure remission at one year and 39 (38.6%) at 5 years. Fifty-four patients (53.3%) were free of GTCS in the last 5 years. <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the number and percentage of patients free of seizures in each syndrome. We found no significant differences between the different syndromes in terms of seizure remission at 1<span class="elsevierStyleHsp" style=""></span>year (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0, 136), at 5 years (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.982) and in freedom from GTCS in the last 5 years (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.228).</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">Predictors for seizure freedom at 5 years were analysed. Age, sex, diagnosis, age of seizure onset, presence of GTCS, epilepsy time course, photosensitivity, psychiatric comorbidity and combination therapy were analysed. The factors that were significantly associated with the persistence of seizures at 5 years were the presence of GTCS (OR: 4.8; 95% CI: 1.2–19.1) and combination therapy (OR: 8.6; CI 95%: 1.9–39.4).</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Withdrawal of anti-seizure treatment</span><p id="par0155" class="elsevierStylePara elsevierViewall">Withdrawal of anti-seizure treatment was attempted in 28 patients (27.7%) at some point during the course of epilepsy. One patient had never been on treatment and was seizure-free. Of these 28 patients, 10 patients (35.7%) withdrew treatment of their own accord and 18 (64.3%) withdrew treatment on the advice of the neurologist. The seizure-free period ranges from one to 22 years. Of the 28 patients, 20 (71.4%) had a recurrence of seizures and 8 (28.6%) remained seizure-free. The analysis by subgroups is shown in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>. The differences in terms of seizure recurrence were not statistically significant between the different groups (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.345).</p><p id="par0160" class="elsevierStylePara elsevierViewall">We analysed the triggers for seizure recurrence. No seizure triggers were reported in 50% of the cases. Thirty percent of patients reported poor night's rest, 15% abrupt discontinuation of treatment, 10% reported substance abuse and 5% reported stress and mood disturbance.</p><p id="par0165" class="elsevierStylePara elsevierViewall">Nineteen (95%) of the 20 patients who had seizure recurrence were reintroduced to antiepileptic medication. The most common seizure type at relapse was GTCS (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>17; 85%); followed by myoclonus (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3; 15%) and absences (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2; 10%). Epilepsy was considered resolved (>10 years without seizures and >5 years without treatment) in 5% of cases.</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discussion</span><p id="par0170" class="elsevierStylePara elsevierViewall">JME was the most common subtype of IGE (46.5%) in our series, similar to other series described in the literature.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5–7,9–11</span></a> The second most common type was EGTCS, with the results being somewhat more heterogeneous in this syndrome, where in some series it has been described as the most common subtype.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">Regarding CAE, it must be taken into account that we only included patients who persisted with absence seizures or GTCS in adolescence and who, therefore, were referred to adult neurology outpatient clinics, with the consequent selection bias of resolved CAEs. It should be remembered that when strict diagnostic criteria are followed, this syndrome has a good prognosis with remission rates of up to 82% without drug therapy.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">Our series had a higher female prevalence (56.4%), which is in line with the literature,<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6,8–10</span></a> where a female dominance in this group of patients has been classically described. JAE was the only subtype with a male dominance in our series, although the cause of this finding is unclear; it could be related to the small sample size of our series.</p><p id="par0185" class="elsevierStylePara elsevierViewall">Regarding the type of seizure, a high percentage of patients had GTCS. By definition, 100% of patients with EGTCS, followed by 89.3% in JME, 78.6% in CAE and 78.5% in JAE. These results are similar to previous studies where a high prevalence of GTCS was reported in these patients.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10,11</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">A history of status epilepticus is rare in this group of patients.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11,19,21,22</span></a> Specifically, in our series only 2 patients had this condition, and in both cases it was an absence status. We have not observed in our series any patient with a myoclonic or generalized tonic-clonic status.</p><p id="par0195" class="elsevierStylePara elsevierViewall">In terms of drug analysis, all patients were on broad-spectrum anti-seizure drugs. The most commonly used drug was VPA, as in other series described in the literature,<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9,23</span></a> the drug of choice in most patients and the most effective in patients with IGE,<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> as well as being the most commonly used drug in combination therapy. Due to the current alert regarding the teratogenicity of VPA,<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25,26</span></a> we observed that its use in women of childbearing age has decreased in our series, with LEV being the most widely used drug in this group of patients. Regarding the drug combination, the most effective in our series was LEV<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>VPA and LEV<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>ZNS, although given the small number of patients it is not possible to draw a solid conclusion.</p><p id="par0200" class="elsevierStylePara elsevierViewall">The majority of patients were on monotherapy (71.29%), similar to other studies where the percentage of overall monotherapy use was 78.4%.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> In the analysis by syndromes, we observed differences regarding the use of combination therapy, where the majority of patients with JME and EGTCS received monotherapy (78.7 and 84.6%, respectively). On the other hand, more than half (57.1%) of the patients with JAE are on combination therapy. Possibly these results are due to the greater difficulty in controlling seizures experienced by patients with JAE, where approximately half of the patients show difficulty in controlling seizures, with high percentages of drug resistance and combination therapy use.<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19,21</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">With regard to remission rates, studies are heterogeneous, with remission rates varying widely between studies. As a group overall, a 5-year remission rate of 50–90 % has been reported with adequate anti-seizure treatment.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Our overall remission rate at 5 years was 39.6% and 54.5% for GTCS. Factors associated with poor prognosis are variable between studies, however the presence of GTCS, persistence of epileptiform abnormalities on the electroencephalogram (EEG), generalised paroxysmal fast activity and photoparoxysmal response have been reported.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> We only identified the presence of GTCS as a poor prognostic factor. We did not define EEG characteristics in our study as we did not have access to earlier studies.</p><p id="par0210" class="elsevierStylePara elsevierViewall">Remission rates in JME have been reported to range from 29 to 86% at one year,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> although several studies in recent years seem to be more homogeneous in terms of results, such as the recent study by Vorderwülbecke et al. in 2017<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> and the study by Senf et al. in 2013.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> Both described remission rates for all seizure types at 5 years of 59%, although in both the mean follow-up was 42.5 and 44.6 years, respectively, longer than in our study.</p><p id="par0215" class="elsevierStylePara elsevierViewall">Our JME patients had a terminal remission rate of 70.2% at one year and 61.7% at 5 years for GTCS, although the rate drops to 38.3% if all seizure types are taken into account at 5 years. Our results are similar to those described in the studies mentioned above, except for remission at 5 years for all seizure types, where our percentage is somewhat lower. One explanation could be the difficulty in recognising or correctly identifying myoclonic seizures and absences and the other is that our follow-up time was shorter than these last two studies (17 years in our series vs. 42.5 and 44.6 in these last 2 studies, respectively). However, lower remission rates have been reported in studies such as that of Höfler et al., where the follow-up time was 38 years, reporting a terminal remission at 1<span class="elsevierStyleHsp" style=""></span>year in 62% and at 5 years in 31%.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a></p><p id="par0220" class="elsevierStylePara elsevierViewall">Seizure remission in absence epilepsy is somewhat lower, with remission rates ranging from 21% to 89%.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> Studies on the long-term prognosis of JAE are scarce and the remission rate ranges from 37 to 62% at 2 years.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12,19</span></a> A meta-analysis by Bouma et al. found that the presence of GTCS confers a worse prognosis, with remission rates of 35% versus 78% when only absences are present.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> It should be noted that this study included both patients with CAE and patients with JAE. In our series, patients with JAE and CAE had very similar remission rates. If we only analyse patients without GTCS, 66.6% were seizure-free in the JAE group in the last 5 years and 100% in the CAE subgroup. Although this sample is small, it is consistent with what is described in the literature.</p><p id="par0225" class="elsevierStylePara elsevierViewall">The studies that analyse the prognosis of EGTCS are scarcer. The study by Camfield et al. reports remission rates of 75%<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> and Vorderwülbecke et al. 63% at 5 years.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Our series showed only 38.5% at 5 years. Perhaps these results may be related to the fact that in our sample, withdrawal of antiepileptic medication was attempted in a high percentage of patients (46.2%), although the reason for this higher percentage of withdrawal is unknown.</p><p id="par0230" class="elsevierStylePara elsevierViewall">Remission rates have been shown to correlate positively with longer disease duration in several studies.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13,16</span></a> No differences in seizure freedom were found in our analysis in patients with a longer disease duration.</p><p id="par0235" class="elsevierStylePara elsevierViewall">Finally, regarding the recurrence rate, withdrawal of treatment was attempted in approximately one third of the patients with a recurrence rate of two thirds of the patients. Antiepileptic medication was restarted in all patients, except in one case due to the patient's own choice. The recurrence rates reported in the literature are highly variable and range from 19 to 100% in JAE, from 30 to 100% in JME, and from 18 to 80% in EGTCS.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12,13,19,29</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> It is important to consider the factors associated with recurrence, since as many as 50% of patients in our series reported seizure-precipitating factors. This would be a key factor to consider when assessing withdrawal of anti-seizure treatment.</p><p id="par0240" class="elsevierStylePara elsevierViewall">Analysing our patients who did not relapse after withdrawal of anti-seizure treatment, we observed one patient with JME with myoclonic seizures and GTCS; 4 patients with absence epilepsy (2 with JAE and 2 with CAE), none of whom had GTCS; and 3 patients with EGTCS. In contrast, of the patients who relapsed, all had GTCS. The sample is small, although consistent with the prognostic factors described in the literature, where the presence of GTCS confers a worse prognosis.<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21,30</span></a></p><p id="par0245" class="elsevierStylePara elsevierViewall">The limitations of our study include the fact that it is a retrospective study, with the inherent constraints that this entails in the collection of information. In addition, all the patients come from a tertiary hospital specialised outpatient clinic, so the more refractory cases could be over-represented, apart from the selection bias of resolved CAEs, which have not been included in this study. Given the number of epilepsy patients seen annually at our centre, we would expect to find a higher number of patients with IGE. Some of these patients may not be registered correctly, so we have not been able to include them in the analysis. Diagnostic criteria between the different syndromes sometimes do not have clear boundaries and there could be an overlap. Key to its correct classification is the most common seizure subtype, the age of onset and EEG characteristics. It should also be noted that myoclonic seizures and absences are sometimes difficult to recognise and are often underestimated due to their subtle characteristics.</p><p id="par0250" class="elsevierStylePara elsevierViewall">In conclusion, the most common subtype was JME, observing differences in terms of combination therapy in the different subgroups. We have not observed significant differences in long-term prognosis or in seizure recurrence rates after withdrawal of anti-seizure treatment between the different syndromes, but we have identified a worse prognosis in patients with GTCS, as well as a high percentage of patients who report a triggering factor for seizure recurrence after treatment discontinuation, which are key factors to consider when assessing treatment withdrawal. Therefore, future efforts should be directed towards trying to define prognostic factors for freedom from seizures and individual risk of recurrence.</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Funding</span><p id="par0255" class="elsevierStylePara elsevierViewall">This research has not received specific funding from public or private sector agencies or non-profit organisations.</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conflict of interests</span><p id="par0260" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:15 [ 0 => array:3 [ "identificador" => "xres1858350" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Purpose" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1615625" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1858351" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1615626" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Inclusion criteria" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Exclusion criteria" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Variables" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] 10 => array:3 [ "identificador" => "sec0035" "titulo" => "Results" "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Patient characteristics" ] 1 => array:2 [ "identificador" => "sec0045" "titulo" => "The characteristics of each group are summarized in Table 1" ] 2 => array:2 [ "identificador" => "sec0050" "titulo" => "Seizure type" ] 3 => array:2 [ "identificador" => "sec0055" "titulo" => "Drugs" ] 4 => array:2 [ "identificador" => "sec0060" "titulo" => "Seizure freedom" ] 5 => array:2 [ "identificador" => "sec0065" "titulo" => "Withdrawal of anti-seizure treatment" ] ] ] 11 => array:2 [ "identificador" => "sec0070" "titulo" => "Discussion" ] 12 => array:2 [ "identificador" => "sec0075" "titulo" => "Funding" ] 13 => array:2 [ "identificador" => "sec0080" "titulo" => "Conflict of interests" ] 14 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-04-30" "fechaAceptado" => "2022-06-26" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1615625" "palabras" => array:5 [ 0 => "Antiepileptic drug" 1 => "Idiopathic generalized epilepsy" 2 => "Outcome" 3 => "Relapse" 4 => "Remission" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1615626" "palabras" => array:5 [ 0 => "Epilepsia generalizada idiopática" 1 => "Pronóstico" 2 => "Recidiva" 3 => "Remisión" 4 => "Tratamiento anticrisis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Purpose</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Idiopathic generalized epilepsies (IGI) are an electroclinical syndrome that include four subsyndromes according to the ILAE 2017 classification. The long-term prognosis of these syndromes is uncertain due to the scarcity and heterogeneity of the studies. The objective of this study is to analyze the long-term prognosis of these syndromes, pharmacological treatment and the seizure recurrence.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Observational and retrospective study of a serie of patients diagnosed with EGI. Epidemiological variables, pharmacological treatment, freedom of seizures and recurrence after withdrawal of treatment were collected.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">We included 101 patients, the majority women (56.4%), with a median evolution of epilepsy of 17 years (interquartile range: 7–31). The most frequent syndrome was juvenile myoclonic epilepsy (46.5%), followed by epilepsy with generalized tonic-clonic seizures alone (25.7%), juvenile absence epilepsy (13.9%) and childhood absence epilepsy (13.9%). 71.29% were on monotherapy and 20.79% on polytherapy, with significant differences between the different syndromes (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.001). The most widely used drug was valproic acid. 39.6% presented seizure remission at 5 years, but we did not observe significant differences between the different syndromes (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.982). The recurrence rate was 71.4% after withdrawal of treatment.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Juvenile myoclonic epilepsy was the most frequent subtype of IGE. We observed significant differences in terms of polytherapy in the different syndromes, although not in the rates of remission of seizures at one year and at five years. The majority of patients with treatment withdrawal relapsed.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Purpose" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Las epilepsias generalizadas idiopáticas (EGI) son un síndrome electroclínico que comprende cuatro subsíndromes según la clasificación de la ILAE 2017. El pronóstico a largo plazo de estos síndromes es incierto debido a la escasez y a la heterogeneidad de los estudios. El objetivo de este trabajo es analizar el pronóstico a largo plazo de estos síndromes, el tratamiento farmacológico y la recurrencia de crisis.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional y retrospectivo de una serie de pacientes diagnosticados de EGI. Se recogieron variables demográficas, tratamiento farmacológico, libertad de crisis y recurrencia tras su retirada.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Incluimos 101 pacientes, la mayoría mujeres (56,4%), con una mediana de evolución de la epilepsia de 17 años (rango intercuartílico: 7–31). El síndrome más frecuente fue la epilepsia mioclónica juvenil (46,5%), seguido de la epilepsia con solo crisis tónico-clónicas generalizadas (25,7%), la epilepsia de ausencia juvenil (13,9%) y la epilepsia de ausencia infantil (13,9%). Un 71,29% estaba en monoterapia y un 20,79% en politerapia, con diferencias entre los diferentes síndromes (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,001). El fármaco más utilizado fue el ácido valproico. El 39.6% presentaba remisión de crisis a los 5 años, pero no observamos diferencias significativas entre los diferentes síndromes (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,982). La tasa de recurrencia fue del 71,4% tras retirada de tratamiento.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">La epilepsia mioclónica juvenil fue el subtipo de EGI más frecuente. Observamos diferencias significativas en cuanto a politerapia entre los diferentes síndromes, aunque no en las tasas de remisión al año y a los cinco años. La mayoría de pacientes a los que se retiró la medicación antiepiléptica recidivaron.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "multimedia" => array:4 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">CAE, childhood absence epilepsy; JAE, juvenile absence epilepsy; EGTCS, epilepsy with generalized tonic-clonic seizures only; JME, juvenile myoclonic epilepsy.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Values are expressed as total number and percentage of total syndrome for qualitative variables and as median and interquartile range (IQR) for quantitative variables.</p>" "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">JME n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>47 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">JAE n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>14 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">EGTCS n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>26 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CAE n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>14 \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Women; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (61.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (35.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (53.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (64.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Seizure onset age; median (IQR), years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (12−17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.5 (10−13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (15−20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.5 (4−7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Current age; median (IQR), years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 (26−42) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.5 (22−47) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36.5 (25−28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35.5 (28−42) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Last follow-up age; median (IQR), years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (24−40) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (21−47) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (23−47) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 (23−41) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Time course of epilepsy; median (IQR), years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (6−26) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.5 (8−37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.5 (4−33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (16−40) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">GTCS; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 (89.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (78.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (78.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Myoclonus; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (14.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">— \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">— \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Absences; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (21.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">— \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Family history; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (29.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (57.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (15.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (28.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Psychiatric comorbidity; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (19.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (28.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (7.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (7.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Status epilepticus history; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (7.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (7.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Demographic variables of the different syndromes.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">CAE, childhood absence epilepsy; JAE, juvenile absence epilepsy; EGTCS, epilepsy with generalized tonic-clonic seizures; JME, juvenile myoclonic epilepsy.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Values are expressed in total number and percentage of the total syndrome.</p>" "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">JME \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">JAE \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">EGTCS \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CAE \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No drugs; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (4.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (11.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (21.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Monotherapy; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 (78.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (42.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (84.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (50) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Combination therapy; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (57.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (3.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (28.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Number and percentage of patients on monotherapy, combination therapy and no treatment in each of the different syndromes.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">BRV, brivaracetam; CAE, childhood absence epilepsy; JAE, juvenile absence epilepsy; EGTCS, epilepsy with generalized tonic-clonic seizures; JME, juvenile myoclonic epilepsy; ESM, ethosuximide; LEV, levetiracetam; LTG, lamotrigine; PER, perampanel; TPM, topiramate; VPA, valproic acid; ZNS, zonisamide.</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Values are expressed in total number and percentage of the total syndrome.</p>" "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">JME \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">JAE \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">EGTCS \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CAE \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">VPA; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (39.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (21.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (37.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 (37.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LEV; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (24.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (16.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (18.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (19.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LTG; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (11.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (17.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (20.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (31.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (17.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ZNS; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (11.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (8.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (6.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PER; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (17.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (5.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ETX; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (17.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (5.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BRV; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (7.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (4.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (4.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TPM; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (4.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (8.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (2.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PB; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">116 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Use of anti-seizure drugs in the different syndromes.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">GTCS, generalized tonic-clonic seizures; CAE, childhood absence epilepsy; JAE, juvenile absence epilepsy; EGTCS, epilepsy with generalized tonic-clonic seizures; JME, juvenile myoclonic epilepsy.</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The results are expressed in total number and percentage of the total for each syndrome.</p>" "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">JME n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>47 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">JAE n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>14 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">EGTCS n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>26 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CAE n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>14 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Remission 1<span class="elsevierStyleHsp" style=""></span>year; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (70.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (64.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (88.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (57.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.136 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Remission 5 years; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (38.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (42.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (38.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (42.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.982 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Remission 5 years GTCS; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (61.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (64.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (38.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (50%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.228 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Drug withdrawal; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (17%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (28.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (46.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (28.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.068 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Recurrence; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (87.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (50%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (75%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (50%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.345 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Resolved epilepsy; n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (3.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (21.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.067 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Remission for all types of seizures at 1<span class="elsevierStyleHsp" style=""></span>year and 5 years and only GTCS at 5 years in the different syndromes.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Proposal for revised classification of epilepsies and epileptic syndromes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Commission on Classification and Terminology of the International League Against Epilepsy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1528-1157.1989.tb05316.x" "Revista" => array:6 [ "tituloSerie" => "Epilepsia" "fecha" => "1989" "volumen" => "30" "paginaInicial" => "389" "paginaFinal" => "399" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2502382" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I.E. Scheffer" 1 => "S. Berkovic" 2 => "G. Capovilla" 3 => "M.B. Connolly" 4 => "J. French" 5 => "L. Guilhoto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/epi.13709" "Revista" => array:6 [ "tituloSerie" => "Epilepsia." "fecha" => "2017" "volumen" => "58" "paginaInicial" => "512" "paginaFinal" => "521" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28276062" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How to diagnose and classify idiopathic (genetic) generalized epilepsies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.D. Elmali" 1 => "S. Auvin" 2 => "T. Bast" 3 => "G. Rubboli" 4 => "M. Koutroumanidis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1684/epd.2020.1192" "Revista" => array:6 [ "tituloSerie" => "Epileptic Disord." "fecha" => "2020" "volumen" => "22" "paginaInicial" => "399" "paginaFinal" => "420" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32782228" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The prognosis of idiopathic generalized epilepsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "U. Seneviratne" 1 => "M. Cook" 2 => "W. D’Souza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1528-1167.2012.03723.x" "Revista" => array:6 [ "tituloSerie" => "Epilepsia." "fecha" => "2012" "volumen" => "53" "paginaInicial" => "2079" "paginaFinal" => "2090" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23106474" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of juvenile myoclonic epilepsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.S. Camfield" 1 => "P. Striano" 2 => "P.R. Camfield" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.yebeh.2012.06.024" "Revista" => array:7 [ "tituloSerie" => "Epilepsy Behav." "fecha" => "2013" "volumen" => "28" "numero" => "Suppl 1" "paginaInicial" => "S15" "paginaFinal" => "7" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23756473" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology and outcome of idiopathic generalized epilepsy in adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Gesche" 1 => "J. Christensen" 2 => "H. Hjalgrim" 3 => "G. Rubboli" 4 => "C.P. Beier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ene.14142" "Revista" => array:6 [ "tituloSerie" => "Eur J Neurol." "fecha" => "2020" "volumen" => "27" "paginaInicial" => "676" "paginaFinal" => "684" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31838768" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of idiopathic generalized epilepsies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Jallon" 1 => "P. Latour" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1528-1167.2005.00309.x" "Revista" => array:7 [ "tituloSerie" => "Epilepsia." "fecha" => "2005" "volumen" => "46" "numero" => "Suppl 9" "paginaInicial" => "10" "paginaFinal" => "14" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16302871" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A study of idiopathic generalised epilepsy in an Irish population" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G.M. Mullins" 1 => "S.S. O’sullivan" 2 => "A. Neligan" 3 => "A. McCarthy" 4 => "B. McNamara" 5 => "R.J. Galvin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.seizure.2006.12.007" "Revista" => array:6 [ "tituloSerie" => "Seizure." "fecha" => "2007" "volumen" => "16" "paginaInicial" => "204" "paginaFinal" => "210" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17223580" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Idiopathic generalized epilepsy: Phenotypic and electroencephalographic observations in a large cohort from South India" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Sinha" 1 => "M.N. Pramod" 2 => "S. Dilipkumar" 3 => "P. Satishchandra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0972-2327.112455" "Revista" => array:6 [ "tituloSerie" => "Ann Indian Acad Neurol." "fecha" => "2013" "volumen" => "16" "paginaInicial" => "163" "paginaFinal" => "168" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23956556" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A clinical study of syndromes of idiopathic (genetic) generalized epilepsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.A. Asadi-Pooya" 1 => "M. Emami" 2 => "M.R. Sperling" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jns.2012.10.014" "Revista" => array:6 [ "tituloSerie" => "J Neurol Sci." "fecha" => "2013" "volumen" => "324" "paginaInicial" => "113" "paginaFinal" => "117" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23149265" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Classification of idiopathic generalised epilepsies in patients over 16 years of age" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Sala-Padro" 1 => "M. Toledo" 2 => "E. Santamarina" 3 => "M. Gonzalez-Cuevas" 4 => "M. Raspall-Chaure" 5 => "M. Sueiras-Gil" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Neurol." "fecha" => "2017" "volumen" => "64" "paginaInicial" => "49" "paginaFinal" => "54" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28074997" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relapse after treatment withdrawal of antiepileptic drugs for Juvenile Absence Epilepsy and Juvenile Myoclonic Epilepsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Healy" 1 => "M. Moran" 2 => "S. Singhal" 3 => "M.F. O’Donoghue" 4 => "R. Alzoubidi" 5 => "W.P. Whitehouse" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.seizure.2018.05.015" "Revista" => array:6 [ "tituloSerie" => "Seizure." "fecha" => "2018" "volumen" => "59" "paginaInicial" => "116" "paginaFinal" => "122" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29807291" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term outcome in adolescent-onset generalized genetic epilepsies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.J. Vorderwülbecke" 1 => "A.B. Kowski" 2 => "A. Kirschbaum" 3 => "H. Merkle" 4 => "P. Senf" 5 => "D. Janz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/epi.13761" "Revista" => array:6 [ "tituloSerie" => "Epilepsia." "fecha" => "2017" "volumen" => "58" "paginaInicial" => "1244" "paginaFinal" => "1250" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28464258" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Refractory juvenile myoclonic epilepsy: a meta-analysis of prevalence and risk factors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Stevelink" 1 => "B.P.C. Koeleman" 2 => "J.W. Sander" 3 => "F.E. Jansen" 4 => "K.P.J. Braun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ene.13811" "Revista" => array:6 [ "tituloSerie" => "Eur J Neurol." "fecha" => "2019" "volumen" => "26" "paginaInicial" => "856" "paginaFinal" => "864" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30223294" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognosis of juvenile myoclonic epilepsy 45 years after onset: seizure outcome and predictors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Senf" 1 => "B. Schmitz" 2 => "M. Holtkamp" 3 => "D. Janz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1212/01.wnl.0000437303.36064.f8" "Revista" => array:6 [ "tituloSerie" => "Neurology." "fecha" => "2013" "volumen" => "81" "paginaInicial" => "2128" "paginaFinal" => "2133" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24212391" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Juvenile myoclonic epilepsy: long-term prognosis and antiepileptic drug withdrawal" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Viloria Alebesque" 1 => "E. Bellosta Diago" 2 => "S. Santos Lasaosa" 3 => "J.A. Mauri Llerda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.23938/ASSN.0756" "Revista" => array:7 [ "tituloSerie" => "An Sist Sanit Navar." "fecha" => "2020" "volumen" => "43" "paginaInicial" => "43" "paginaFinal" => "49" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32139911" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673616323807" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Juvenile myoclonic epilepsy: long-term prognosis and risk factors" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Pietrafusa" 1 => "A. La Neve" 2 => "L. de Palma" 3 => "G. Boero" 4 => "C. Luisi" 5 => "F. Vigevano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.braindev.2021.02.005" "Revista" => array:6 [ "tituloSerie" => "Brain Dev." "fecha" => "2021" "volumen" => "43" "paginaInicial" => "688" "paginaFinal" => "697" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33781581" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Juvenile myoclonic epilepsy 25 years after seizure onset: a population-based study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.S. Camfield" 1 => "P.R. Camfield" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1212/WNL.0b013e3181b9c86f" "Revista" => array:6 [ "tituloSerie" => "Neurology" "fecha" => "2009" "volumen" => "73" "paginaInicial" => "1041" "paginaFinal" => "1045" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19786695" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long term prognosis of juvenile absence epilepsy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Aiguabella Macau" 1 => "M. Falip Centellas" 2 => "M. Veciana de Las Heras" 3 => "M.A. Climent Perín" 4 => "J. Miró Lladó" 5 => "I. Moreno Gómez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nrl.2010.09.005" "Revista" => array:6 [ "tituloSerie" => "Neurologia." "fecha" => "2011" "volumen" => "26" "paginaInicial" => "193" "paginaFinal" => "199" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21163225" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Idiopathic generalized epilepsy with generalized tonic-clonic seizures (IGE-GTC): a population-based cohort with >20 year follow up for medical and social outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Camfield" 1 => "C. Camfield" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.yebeh.2010.02.014" "Revista" => array:6 [ "tituloSerie" => "Epilepsy Behav." "fecha" => "2010" "volumen" => "18" "paginaInicial" => "61" "paginaFinal" => "63" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20471324" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term seizure outcome in patients with juvenile absence epilepsy; a retrospective study in a tertiary referral center" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Danhofer" 1 => "M. Brázdil" 2 => "H. Ošlejšková" 3 => "R. Kuba" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.seizure.2014.03.002" "Revista" => array:6 [ "tituloSerie" => "Seizure." "fecha" => "2014" "volumen" => "23" "paginaInicial" => "443" "paginaFinal" => "447" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24684814" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Myoclonic status epilepticus in juvenile myoclonic epilepsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Larch" 1 => "I. Unterberger" 2 => "G. Bauer" 3 => "J. Reichsoellner" 4 => "G. Kuchukhidze" 5 => "E. Trinka" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1684/epd.2009.0284" "Revista" => array:6 [ "tituloSerie" => "Epileptic Disord." "fecha" => "2009" "volumen" => "11" "paginaInicial" => "309" "paginaFinal" => "314" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20045780" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antiepileptic drug withdrawal in juvenile myoclonic epilepsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Syvertsen" 1 => "I. Fløgstad" 2 => "U. Enger" 3 => "C.J. Landmark" 4 => "J. Koht" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ane.13042" "Revista" => array:6 [ "tituloSerie" => "Acta Neurol Scand." "fecha" => "2019" "volumen" => "139" "paginaInicial" => "192" "paginaFinal" => "198" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30378684" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The SANAD study of effectiveness of valproate, lamotrigine, or topiramate for generalised and unclassifiable epilepsy: an unblinded randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.G. Marson" 1 => "A.M. Al-Kharusi" 2 => "M. Alwaidh" 3 => "R. Appleton" 4 => "G.A. Baker" 5 => "D.W. Chadwick" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(07)60461-9" "Revista" => array:5 [ "tituloSerie" => "Lancet." "fecha" => "2007" "volumen" => "369" "paginaInicial" => "1016" "paginaFinal" => "1026" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Changing trends in antiepileptic drug prescribing in girls of child-bearing potential" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Ackers" 1 => "F.M. Besag" 2 => "A. Wade" 3 => "M.L. Murray" 4 => "I.C. Wong" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/adc.2008.144386" "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child." "fecha" => "2009" "volumen" => "94" "paginaInicial" => "443" "paginaFinal" => "447" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19307197" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparative risk of major congenital malformations with 8 different antiepileptic drugs: a prospective cohort study of the EURAP registry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D.G. Vossler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/1535759719835353" "Revista" => array:6 [ "tituloSerie" => "Epilepsy Curr." "fecha" => "2019" "volumen" => "19" "paginaInicial" => "83" "paginaFinal" => "85" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30955418" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Seizure outcome in 175 patients with juvenile myoclonic epilepsy-a long-term observational study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Höfler" 1 => "I. Unterberger" 2 => "J. Dobesberger" 3 => "G. Kuchukhidze" 4 => "G. Walser" 5 => "E. Trinka" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eplepsyres.2014.09.008" "Revista" => array:6 [ "tituloSerie" => "Epilepsy Res." "fecha" => "2014" "volumen" => "108" "paginaInicial" => "1817" "paginaFinal" => "1824" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25443450" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The outcome of absence epilepsy: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P.A. Bouma" 1 => "R.G. Westendorp" 2 => "J.G. van Dijk" 3 => "A.C. Peters" 4 => "O.F. Brouwer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1212/wnl.47.3.802" "Revista" => array:6 [ "tituloSerie" => "Neurology." "fecha" => "1996" "volumen" => "47" "paginaInicial" => "802" "paginaFinal" => "808" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8797483" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antiepileptic drugs withdrawal in patients with idiopathic generalized epilepsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Pavlović" 1 => "N. Jović" 2 => "T. Pekmezović" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.seizure.2011.03.007" "Revista" => array:6 [ "tituloSerie" => "Seizure." "fecha" => "2011" "volumen" => "20" "paginaInicial" => "520" "paginaFinal" => "525" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21493107" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors for long-term seizure outcome in juvenile myoclonic epilepsy: 25–63 years of follow-up" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Geithner" 1 => "F. Schneider" 2 => "Z. Wang" 3 => "J. Berneiser" 4 => "R. Herzer" 5 => "C. Kessler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1528-1167.2012.03526.x" "Revista" => array:6 [ "tituloSerie" => "Epilepsia." "fecha" => "2012" "volumen" => "53" "paginaInicial" => "1379" "paginaFinal" => "1386" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22686598" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016000000005/v1_202303052139/S2387020623000505/v1_202303052139/en/main.assets" "Apartado" => array:4 [ "identificador" => "43310" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016000000005/v1_202303052139/S2387020623000505/v1_202303052139/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623000505?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 July | 4 | 3 | 7 |
| 2023 March | 5 | 0 | 5 |
