{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:48:35Z","timestamp":1791330515425,"version":"4.3.1"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,2,11]],"date-time":"2014-02-11T00:00:00Z","timestamp":1392076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"National Institutes of Health, National Institute of NEurological Disorders and Stroke","award":["R37-NS31146"],"award-info":[{"award-number":["R37-NS31146"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2014,4]]},"abstract":"Summary<\/jats:title>\n \n Objective<\/jats:title>\n \n Examine the possible association between long\u2010term seizure outcome in childhood absence epilepsy (\n CAE<\/jats:styled-content>\n ) and the initial treatment choice.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Children with\n CAE<\/jats:styled-content>\n were prospectively recruited at initial diagnosis and followed in a community\u2010based cohort study. Children presenting with convulsive seizures, significant imaging abnormalities, or who were followed <5\u00a0years were excluded. Early outcomes included success of initial medication, early remission, and pharmacoresistance. The primary long\u2010term outcome was complete remission: \u22655\u00a0years both seizure free and medication free. Survival methods were used for analyses.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The first medication was ethosuximde (\n ESM<\/jats:styled-content>\n ) in 41 (69%) and valproic acid (\n VPA<\/jats:styled-content>\n ) in 18 (31%). Initial success rates were 59% (\n ESM<\/jats:styled-content>\n ) and 56% (\n VPA<\/jats:styled-content>\n ). Early remission and pharmacoresistance were similar in each group. Apart from atypical electroencephalography (EEG) features (61% [\n VPA<\/jats:styled-content>\n ], 17% [\n ESM<\/jats:styled-content>\n ]), no clinical features varied substantially between the treatment groups. Complete remission occurred in 31 children (76%) treated with\n ESM<\/jats:styled-content>\n and 7 (39%) who received\n VPA<\/jats:styled-content>\n (p\u00a0=\u00a00.007). Children with versus without atypical\n EEG<\/jats:styled-content>\n features were less likely to enter complete remission (50% vs. 71%, p\u00a0=\u00a00.03). In a Cox regression,\n ESM<\/jats:styled-content>\n was associated with a higher rate of complete remission than\n VPA<\/jats:styled-content>\n (hazards ratio [\n HR<\/jats:styled-content>\n ]\u00a02.5, 95% confidence interval [CI] 1.1\u20136.0; p\u00a0=\u00a00.03). Atypical\n EEG<\/jats:styled-content>\n features did not independently predict outcome (p\u00a0=\u00a00.15). Five\u2010year and 10\u2010year remission, regardless of continued treatment, occurred more often in children initially treated with\n ESM<\/jats:styled-content>\n versus\n VPA<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Significance<\/jats:title>\n \n These findings are congruent with results of studies in genetic absence models in rats and provide preliminary evidence motivating a hypothesis regarding potential disease\u2010modifying effects of\n ESM<\/jats:styled-content>\n in CAE.\n <\/jats:p>\n \n A PowerPoint slide summarizing this article is available for download in the Supporting Information section\n here<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/epi.12551","type":"journal-article","created":{"date-parts":[[2014,2,12]],"date-time":"2014-02-12T05:36:37Z","timestamp":1392183397000},"page":"551-557","source":"Crossref","is-referenced-by-count":70,"title":["Long\u2010term seizure remission in childhood absence epilepsy: Might initial treatment matter?"],"prefix":"10.1111","volume":"55","author":[{"given":"Anne T.","family":"Berg","sequence":"first","affiliation":[{"name":"Department of Pediatrics Epilepsy Center Ann & Robert H. Lurie Children's Hospital of Chicago Chicago Illinois U.S.A"},{"name":"the Northwestern Memorial Feinberg School of Medicine Chicago Illinois U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan R.","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Neurology Yale School of Medicine New Haven Connecticut U.S.A"},{"name":"Department of Pediatrics Yale School of Medicine New Haven Connecticut U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francine M.","family":"Testa","sequence":"additional","affiliation":[{"name":"Department of Neurology Yale School of Medicine New Haven Connecticut U.S.A"},{"name":"Department of Pediatrics Yale School of Medicine New Haven Connecticut U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hal","family":"Blumenfeld","sequence":"additional","affiliation":[{"name":"Department of Neurology Yale School of Medicine New Haven Connecticut U.S.A"},{"name":"Department of Neurobiology Yale School of Medicine New Haven Connecticut U.S.A"},{"name":"Department of Neurosurgery Yale School of Medicine New Haven Connecticut U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,2,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awp187"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1998.tb01382.x"},{"key":"e_1_2_7_4_1","first-page":"113","volume-title":"Prognosis of epilepsies","author":"Camfield P","year":"2003"},{"key":"e_1_2_7_5_1","volume-title":"Epileptic syndromes in infancy, childhood, and adolescence","author":"Roger 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