May 03, 2022; 98 (18) Research Article
Electroclinical Features and Long-term Seizure Outcome in Patients With Eyelid Myoclonia With Absences
Emanuele Cerulli Irelli, View ORCID ProfileEnrico Cocchi, View ORCID ProfileGeorgia Ramantani, Roberto H. Caraballo, Loretta Giuliano, View ORCID ProfileTulay Yilmaz, Alessandra Morano, Eleni Panagiotakaki, Francesca F. Operto, Beatriz Gonzalez Giraldez, Katri Silvennoinen, Sara Casciato, Marion Comajuan, Simona Balestrini, View ORCID ProfileFrancesco Fortunato, Antonietta Coppola, Giancarlo Di Gennaro, View ORCID ProfileAngelo Labate, Vito Sofia, Gerhard J. Kluger, Dorothée G.A. Kasteleijn-Nolst Trenité, View ORCID ProfileAntonio Gambardella, Betul Baykan, Sanjay M. Sisodiya, View ORCID ProfileAlexis Arzimanoglou, View ORCID ProfilePasquale Striano, Carlo Di Bonaventura, on behalf of the EMA Study Group
First published March 15, 2022, DOI: https://doi.org/10.1212/WNL.0000000000200165
Emanuele Cerulli Irelli
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MDEnrico Cocchi
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MDGeorgia Ramantani
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDRoberto H. Caraballo
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MDLoretta Giuliano
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MDTulay Yilmaz
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MDAlessandra Morano
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MDEleni Panagiotakaki
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDFrancesca F. Operto
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MDBeatriz Gonzalez Giraldez
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MDKatri Silvennoinen
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MDSara Casciato
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDMarion Comajuan
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MDSimona Balestrini
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDFrancesco Fortunato
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MDAntonietta Coppola
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDGiancarlo Di Gennaro
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDAngelo Labate
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDVito Sofia
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MDGerhard J. Kluger
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MDDorothée G.A. Kasteleijn-Nolst Trenité
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDAntonio Gambardella
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDBetul Baykan
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDSanjay M. Sisodiya
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDAlexis Arzimanoglou
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDPasquale Striano
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDCarlo Di Bonaventura
From the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
MD, PhDFrom the Department of Human Neurosciences (E.C.I., A.M., C.D.B.), Sapienza, University of Rome, Italy; Department of Precision Medicine and Genomics (E.C.), Department of Medicine, Columbia University, New York, NY; Department of Neuropediatrics (G.R.), University Children's Hospital Zurich, Switzerland; Department of Neurology (R.H.C.), Hospital de Pediatría “Prof. Dr. Juan P Garrahan,” Buenos Aires, Argentina; Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” (L.G., V.S.), Section of Neurosciences, University of Catania, Italy; Departments of Neurology and Clinical Neurophysiology (T.Y., B.B.), Istanbul University, Istanbul Faculty of Medicine, Turkey; Department of Paediatric Clinical Epileptology, Sleep Disorders and Functional Neurology (E.P., M.C., A.A.), University Hospitals of Lyon (HCL), member of the ERN EpiCARE, France; Child and Adolescent Neuropsychiatry Unit (F.F.O.), Department of Medicine, Surgery and Dentistry, University of Salerno, Italy; Epilepsy Unit (B.G.G.), Neurology Service, Hospital Universitario and IIS Fundación Jiménez Díaz and CIBERER, Madrid, Spain; Department of Clinical and Experimental Epilepsy (S.B., K.S., S.M.S.), UCL Queen Square Institute of Neurology, London, UK; IRCCS NEUROMED (S.C., G.D.G.), Pozzilli, Isernia, Italy; Institute of Neurology (S.B.), UCL, London, UK; Institute of Neurology (F.F., A.L., A.G.), University Magna Graecia, Catanzaro, Italy; Department of Neuroscience and Reproductive and Odontostomatological Sciences (A.C.), Federico II University, Naples, Italy; Clinic for Neuropediatrics and Neurorehabilitation (G.J.K.), Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Germany; Department of Neurosurgery and Epilepsy (D.G.A.K.-N.T.), University Medical Center, Utrecht University, the Netherlands; and Pediatric Neurology and Muscular Diseases Unit (P.S.), IRCCS “Istituto Giannina Gaslini,” Genova, Italy.
Electroclinical Features and Long-term Seizure Outcome in Patients With Eyelid Myoclonia With Absences
Emanuele Cerulli Irelli, Enrico Cocchi, Georgia Ramantani, Roberto H. Caraballo, Loretta Giuliano, Tulay Yilmaz, Alessandra Morano, Eleni Panagiotakaki, Francesca F. Operto, Beatriz Gonzalez Giraldez, Katri Silvennoinen, Sara Casciato, Marion Comajuan, Simona Balestrini, Francesco Fortunato, Antonietta Coppola, Giancarlo Di Gennaro, Angelo Labate, Vito Sofia, Gerhard J. Kluger, Dorothée G.A. Kasteleijn-Nolst Trenité, Antonio Gambardella, Betul Baykan, Sanjay M. Sisodiya, Alexis Arzimanoglou, Pasquale Striano, Carlo Di Bonaventura, on behalf of the EMA Study Group
Neurology May 2022, 98 (18) e1865-e1876; DOI: 10.1212/WNL.0000000000200165
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Abstract
Background and Objectives Eyelid myoclonia (EM) with absences (EMA) is a generalized epilepsy syndrome with a prognosis and clinical characteristics that are still partially undefined. We investigated electroclinical endophenotypes and long-term seizure outcome in a large cohort of patients with EMA.
Methods In this multicenter retrospective study, patients with EMA with ≥5 years of follow-up were included. We investigated prognostic patterns and sustained terminal remission (STR), along with their prognostic factors. Moreover, a 2-step cluster analysis was used to investigate the presence of distinct EMA endophenotypes.
Results We included 172 patients with a median age at onset of 7 years (interquartile range [IQR] 5–10 years) and a median follow-up duration of 14 years (IQR 8.25–23.75 years). Sixty-six patients (38.4%) displayed a nonremission pattern, whereas remission and relapse patterns were encountered in 56 (32.6%) and 50 (29.1%) participants. Early epilepsy onset, history of febrile seizures (FS), and EM status epilepticus significantly predicted a nonremission pattern according to multinomial logistic regression analysis. STR was achieved by 68 (39.5%) patients with a mean latency of 14.05 years (SD ±12.47 years). Early epilepsy onset, psychiatric comorbid conditions, and a history of FS and generalized tonic-clonic seizures were associated with a lower probability of achieving STR according to a Cox regression proportional hazards model. Antiseizure medication (ASM) withdrawal was attempted in 62 of 172 patients, and seizures recurred in 74.2%. Cluster analysis revealed 2 distinct clusters with 86 patients each. Cluster 2, which we defined as EMA-plus, was characterized by an earlier age at epilepsy onset, higher rate of intellectual disability, EM status epilepticus, generalized paroxysmal fast activity, self-induced seizures, FS, and poor ASM response, whereas cluster 1, the EMA-only cluster, was characterized by a higher rate of seizure remission and more favorable neuropsychiatric outcome.
Discussion Early epilepsy onset was the most relevant prognostic factor for poor treatment response. A long latency between epilepsy onset and ASM response was observed, suggesting the effect of age-related brain changes in EMA remission. Last, our cluster analysis showed a clear-cut distinction of patients with EMA into an EMA-plus insidious subphenotype and an EMA-only benign cluster that strongly differed in terms of remission rates and cognitive outcomes.
Glossary
- ASM=
- antiseizure medication;
- ECS=
- eye closure sensitivity;
- EM=
- eyelid myoclonia;
- EMA=
- EM with absences;
- FS=
- febrile seizures;
- GGE=
- genetic generalized epilepsies;
- GPFA=
- generalized paroxysmal fast activity;
- GTCS=
- generalized tonic-clonic seizures;
- HR=
- hazard ratio;
- ID=
- intellectual disability;
- IQR=
- interquartile range;
- JME=
- juvenile myoclonic epilepsy;
- LEV=
- levetiracetam;
- LTG=
- lamotrigine;
- OR=
- odds ratio;
- PS=
- photosensitivity;
- PWD=
- polyspike-wave discharges;
- STR=
- sustained terminal remission;
- SWD=
- spike-wave discharge;
- TSCA=
- 2-step cluster analysis;
- VPA=
- valproate
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
EMA Study Group coinvestigators are listed in the Appendix 2 at the end the article.
- Received September 24, 2021.
- Accepted in final form January 21, 2022.
- © 2022 American Academy of Neurology
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