Spektrum kliniczne epilepsji u dzieci leczone w specjalistycznym ośrodku neurologii pediatrycznej - badanie kohortowe w szpitalu
Clinical spectrum of epilepsy in children treated at a tertiary pediatric neurology center-A hospital-based cohort study
W skrócie
Badanie dotyczyło 439 dzieci z epilepsją przyjętych do szpitala w Bratysławie w latach 2020-2022. Badacze klasyfikowali przypadki epilepsji według międzynarodowych wytycznych, wykazując, że najczęściej epilepsja zaczyna się w pierwszym roku życia, dominuje forma ogniskowa, a u ponad jednej trzeciej pacjentów rozpoznano konkretny zespół epileptyczny. Wyniki pokazują, że systematyczne zastosowanie międzynarodowej klasyfikacji epilepsji pozwala lepiej zaplanować leczenie i ocenić rokowanie u każdego dziecka.
Oryginalny abstract (angielski)
BACKGROUND: ILAE introduced a new classification of epilepsies and epileptic seizures in 2017 and a classification of epilepsy syndromes in 2022. Despite increasing adoption in clinical practice, real-world data on their clinical implementation, particularly from Central Europe, remain limited. OBJECTIVE: To retrospectively assess the distribution of epilepsy types, syndromes, and etiologies according to the 2017 and 2022 ILAE classifications and to analyze the distribution of age at seizure onset in a tertiary pediatric neurology department in Slovakia. METHODS: This retrospective single-center study evaluated 439 pediatric patients (aged 0-18 years) with epilepsy who were hospitalized at the Department of Pediatric Neurology in Bratislava between January 2020 and June 2022. RESULTS: Seizure onset most frequently occurred during the first year of life (29.6%). Focal epilepsy was the predominant type, occurring in 237 patients (54.0%), followed by generalized epilepsy in 108 patients (24.6%), combined generalized and focal epilepsy in 66 patients (15.03%), and epilepsy of unknown type in 28 patients (6.38%). An epilepsy syndrome was diagnosed in 155 patients (35.3%). The most common epilepsy syndromes were infantile epileptic spasms syndrome in 31 patients (7.06%), idiopathic generalized epilepsies in 24 patients (5.47%), developmental and/or epileptic encephalopathy with spike- and-wave activation in sleep in 21 patients (4.78%), and self-limited epilepsy with centrotemporal spikes in 20 patients (4.56%). An established etiology was identified in 170 patients (38.72%). Among patients with an established etiology, structural causes were the most frequent in 101 patients. CONCLUSIONS: In this tertiary hospitalized pediatric epilepsy cohort, systematic application of the ILAE classification enabled structured diagnostic categorization and etiological stratification. Early etiological evaluation and structured classification are essential for individualized treatment planning and improved prognostic assessment in children with epilepsy.