Recurrent secondary generalization in XXXX : Predictors and a potential link to surgical outcome?

@entity1 @entity410 @entity302 @entity4940
OBJECTIVE: @entity4940 ( @entity4940 ) frequently leads to secondary generalized @entity410 (SGTCS). However, little is known about the clinical, electrophysiologic, and radiologic correlates of SGTCS and whether these could influence diagnosis and treatment. METHODS: A cohort of 48 @entity1 with confirmed @entity4940 was retrospectively identified and dichotomized into a group with and a group without SGTCS defined by history (>= 1/year) or video-electroencephalography (vEEG). Demographics, @entity410 semiology, vEEG, neuroimaging data, and estimated @entity410 -onset zone were tabulated, and their association with the occurrence of SGTCS was evaluated with use of a chi-square test. Independent predictors of SGTCS were confirmed using a stepwise multivariate analysis. Similarly, these predictors as well as a history of SGTCS were tested as multivariate predictors of the postoperative International League Against @entity302 (ILAE) score in the surgical subgroup (n  =  25). RESULTS: We identified three independent predictors of a history of SGTCS in @entity4940 , including loss of responsiveness at @entity410 onset (corrected p  =  0.04), a semiology involving early elementary motor signs (corrected p  =  0.01), and multifocal spikes on EEG (corrected p  =  0.02). A @entity410 -free outcome occurred in 57% of surgical cases and was more likely in the group without SGTCS (100%, p  =  0.001). When considering only SGTCS occurring during video-EEG monitoring, the association with semiology and surgical outcome vanished, but the association with preserved awareness and a multifocal EEG persisted. SIGNIFICANCE: A history of SGTCS is related to a specific ictal semiology and interictal EEG, and may have a role in surgical risk stratification.
