{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:08:39Z","timestamp":1789668519841,"version":"4.0.1"},"reference-count":40,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T00:00:00Z","timestamp":1602633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess prognostic patterns and investigate clinical and electroencephalography (EEG) variables associated with persistent treatment resistance in a population of genetic generalized epilepsy (GGE) patients with a long\u2010term follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from GGE patients followed from 1975 to 2019 were reviewed retrospectively. Subjects with a follow\u2010up &gt;10\u00a0years, starting from epilepsy diagnosis, were included. Persistent treatment resistance was defined as the absence of any period of remission \u22651\u00a0year despite treatment with two appropriate and adequate antiepileptic drugs (AEDs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred ninety\u2010nine patients were included. The median age was 39.5\u00a0years (interquartile range [IQR] 30\u201049) and the median follow\u2010up was 27\u00a0years (IQR 18\u201035). The most common syndrome was juvenile myoclonic epilepsy (JME), diagnosed in 44.2% of patients. During follow\u2010up, 163 subjects (81.9%) experienced 3\u2010year remission from any seizure type, whereas 5\u2010 and 10\u2010year remission occurred in 141 (70.8%) and 92 (46.2%) cases, respectively. The most common prognostic pattern was a relapsing\u2010remitting course, observed in 80 patients (40.2%), whereas 29 (14.6%) displayed persistent treatment resistance. According to multivariable logistic regression analysis, febrile seizures (FS), specific EEG patterns (namely generalized paroxysmal fast activity, GPFA) and valproate (VPA) resistance were the only variables significantly associated with persistent treatment resistance. JME was the only epilepsy syndrome statistically associated with persistent treatment resistance in univariable logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Persistent treatment resistance was observed in almost 15% of GGE patients followed in a tertiary epilepsy center. A worse outcome was associated with specific clinical variables (JME, FS) and EEG patterns (GPFA).<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.16708","type":"journal-article","created":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T11:51:14Z","timestamp":1602676274000},"page":"2452-2460","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Persistent treatment resistance in genetic generalized epilepsy: A long\u2010term outcome study in a tertiary epilepsy center"],"prefix":"10.1111","volume":"61","author":[{"given":"Emanuele","family":"Cerulli Irelli","sequence":"first","affiliation":[{"name":"Epilepsy Unit Department of Human Neurosciences Policlinico \u201cUmberto I\u201d, \u201cSapienza\u201d University Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Morano","sequence":"additional","affiliation":[{"name":"Epilepsy Unit Department of Human Neurosciences 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