Table 1. Patients' clinical data, subdivided in two subcohorts (A and B), including sex, age, AEDs administered, EEG, MRI results, and family history.
Case n-subcohort | Sex | Age (years) | Diagnosis | Clinical features | AEDsa | EEG | MRI | Family history |
---|---|---|---|---|---|---|---|---|
1-A | F | 17 | Lennox–Gastaut syndrome in a subject with double cortex | Severe mental retardation. Tonic, atonic, and myoclonic seizures during sleep and awake | VPA+CLB+ETS | Lennox like | Double cortex | Questionable parental consanguinity |
2-A | F | 14 | Pyridoxine-dependent epilepsy | Neonatal seizures and epileptic status at 6 months of age responsive to pyridoxine. Normal IQ | LTG+B6 | Currently normal | Normal | Negative |
3-A | M | 14 | Pyridoxine-dependent epilepsy | Intractable seizures during the first year and epileptic status pyridoxine responsive. Normal IQ | B6 | Currently normal | Normal | Progressive motor and language disability (mother's paternal uncle) |
4-A | M | 4 | Dravet syndrome | Typical evolution of Dravet syndrome. Actually IQ 46 | VPA+TPM+CLB+STP | Typical of Dravet syndrome | Normal | Negative |
5-A | F | 0.8 | Benign familial neonatal seizures | Intractable tonic-clonic seizures during the first 25 days of life spontaneously remised | PB+TPM+MDL+Rivotril | Normal | Normal | Father with benign neonatal seizures |
6-A | M | 7 | Epileptic encephalopathy and pervasive developmental disorder | Neonatal seizures, followed by focal seizures. Severe mental retardation. Pervasive developmental disorder | VPA | Sharp and sharp-wave on central and frontal regions | Normal | Negative |
7-A | F | 7 | Febrile seizures plus | Febrile and afebrile GTC. Normal IQ | LEV | Large amplitude and diffuse sharp-wave abnormalities | Normal | Migraine in the maternal line |
8-B(i) | M | 6 | Myoclonic epilepsy | Epileptic negative myoclonus. Normal IQ | VPA+LTG | Spike-wave discharges | Not performed | Brother of 8-B(ii) |
8-B(ii) | M | 14 | Generalized epilepsy | One myoclonic seizure. Normal IQ. | LTG | Spike-slow wave discharges | Normal | Brother of 8-B(i) |
9-B | F | 3 | Febrile seizures | Numerous febrile seizures during the first year. Normal psychomotor development (GQ=116) | VPA | Normal | Not performed | Family history of febrile seizures |
10-B | M | 6 | Benign epilepsy of childhood with centrotemporal spikes (BECTS) | Few typical rolandic seizures. Borderline learning difficulties | None | Atypical BECTS | Normal | Family history of BECTS and mild intellectual disabilities |
11-B | M | 8 | Myoclonic epilepsy | Cognitive impairment from 4 years (GQ 90.4; IQ 53) | VPA+LTG | Currently normal | Not performed | Mother, maternal uncle, and grandfather with generalized epilepsy |
12-B | M | 16 | Febrile seizures plus | Febrile seizures from 2 to 6 years. Normal IQ | VPA, suspended in 2006 | Currently normal | Not performed | Family history of febrile afebrile seizures |
13-B | F | 5 | Febrile seizures | Febrile seizures, normal IQ | None | Normal | Not performed | Family history of febrile seizures (father) and FS and absences (mother) |
14-B | M | 12 | Febrile seizures plus | Febbrile seizures, then afebrile GTC. Normal IQ | VPA | Generalized abnormalities | Hippocampal asymmetry, incomplete rotation of hippocampal structure | Family history febrile and afebrile seizures (father and sister) |
15-B | M | 9 | Lennox–Gastaut syndrome | Severe cognitive impairment, myoclonic and tonic seizures or GTC Mental retardation | VPA+ETS+NTZ+HC+PB | Spikes and polyspikes tonic activity, slow waves during sleep and awake | Normal | Not reported |
16-B | M | 3 | Epileptic encephalopathy | GTC and partial seizures. Severe cognitive impairment | LTG+VPA+HC | Generalized sharps and sharp waves. Poor organization. | Normal | Consanguineous parents (first cousins) |
17-B | M | 4 | Focal epilepsy | Febrile seizures, status epilepticus. Normal psychomotor development. QS 90 at 2 years | VPA+TPM | Poor organization, slow, not epileptic abnormalities | Mesial temporal sclerosis and temporal lobe dysplasia left | Not reported |
18-B | M | 4 | Epileptic encephalopathy | Neonatal seizures, spasms, and hypsarrhythmia Severe cognitive impairment, hypotonia, strabismus, and motor stereotypies | VPA+LEV+NTZ | Poor organization, slow, slow waves, and polispikes during sleep | Cerebral atrophy | Not reported |
19-B | M | 5 | Epileptic encephalopathy and hypothyroidism | Severe cognitive impairment, spasms in flexion, and partial seizures, Hypothyroidism | VPA+TPM+LTG | Poor organization. Multifocal abnormalities | Modest diffuse cerebral atrophy | Not reported |
Abbreviations: AEDs, antiepileptic drugs; EEG, electroencephalogram; F, female; M, male; MRI, magnetic resonance imaging.
AEDs abbreviations: B6, pyridoxine; CBZ, carbamazepine; CLB, clobazam; ETS, ethosuximide; HC, hydrocortisone; LEV, levetiracetam; LTG, lamotrigine; MDL, midazolam; NTZ, nitrazepam; PB, phenobarbital; STP, stiripentol; TPM, topiramate; VPA, valproic acid.