Epilepsia de ausencias en la niñez y adolescencia, diagnóstico, tratamiento y pronóstico

Abstract

Typical absence seizures are part of a group of idiopathic generalized epileptic syndromes, including childhood absence epilepsy (CAE) and juvenile absence epilepsy (JAE). Typical absences are the main clinical feature of these syndromes whose characteristics include transient loss of consciousness of sudden onset and termination without loss of muscle tone with a variable degree of automatisms whose frequency and severity may vary according to each case. Pathophysiologically, crises are associated with overactivation of the thalamic-cortical circuit. CAE is usually associated with a good prognosis with a high percentage of remission, while JAE is usually a disorder that persists for life. Pharmacological treatment is based on the use of anticonvulsants such as ethosuximide, valproic acid and lamotrigine. Absences can also manifest atypically, which usually occur in Lennox Gastaut Syndrome, Epilepsy with myoclonic-atonic seizures, epileptic encephalopathy with spike and continuous wave during sleep (CSWS), among others. Generally, this type of crisis associates an unfavorable prognosis in which therapeutic goals are often focused on achieving a reduction in the incidence of crises and not complete remission.