Abstract Details

Title Patterns of Antiseizure Medication Use and Therapeutic Load in Adults with Developmental and Epileptic Encephalopathies: A Single-center Study

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 10-008

Objective To describe patterns of antiseizure medication (ASM) use, common combinations, and their clinical associations with therapeutic load in adults with developmental and epileptic encephalopathies (DEEs).

Background Developmental and epileptic encephalopathies (DEEs) are characterized by drug-resistant seizures and developmental delay or regression. (1) Despite multiple studies, therapeutic and surgical interventions do not consistently achieve seizure freedom. (2)

Design/Methods A retrospective cross-sectional study of 82 adult patients with DEEs who were followed at an epilepsy center was conducted. Clinical data were collected, including ASM use, combinations, and therapeutic load (high [≥3 ASMs] vs low [1-2 ASMs]), and were recorded. Descriptive analyses were performed. Spearman’s correlations assessed the relationship between epilepsy duration and the number of ASMs. Logistic regression was used to evaluate predictors of high therapeutic load.

Results

Eighty-two patients were included, 29 (35.4%) female and 53 (64.6%) male, with a mean age of 33.3 ± 8.7 years and a mean follow-up of 13.2 years. The most frequent seizure type was generalized, 52 (63.4%).

The most frequent ASM combination was lamotrigine-topiramate-valproate in 7 (8.5%), followed by clobazam-lamotrigine-levetiracetam-valproate in 4 (4.9%), clobazam-levetiracetam-valproate in 4 (4.9%), and clonazepam-lamotrigine-valproate in 4 (4.9%). Valproate was included in 63 (76.8%) combinations. The mean number of ASMs per patient was 3.3 ± 0.96. No significant correlation was found between epilepsy duration and number of ASMs (Spearman’s ρ = −0.09, p = 0.41). Logistic regression showed no significant association between etiology and high therapeutic load (OR 0.78, 95% CI 0.56–1.08, p = 0.13).

Conclusions In this cohort of adults with DEEs, therapeutic load was not associated with disease duration or etiology. Valproate-based polytherapy remains the cornerstone of treatment despite the availability of newer ASMs. These findings highlight stable prescribing patterns and the need for individualized long-term strategies in the management of adult patients with DEEs.

Authors/Disclosures
Fernando Vasquez Lopez, MD PRESENTER	Dr. Vasquez Lopez has nothing to disclose.
Juan C. Vera, Jr., Medical Student	Dr. Vera has nothing to disclose.
Maximiliano D. Salgado Deza	Maximiliano D. Salgado Deza has nothing to disclose.
Salvador Martinez-Medina, MD	Dr. Martinez-Medina has nothing to disclose.
Stefan Narvaez-Labuhn, Medical Student	Mr. Narvaez-Labuhn has nothing to disclose.
Irving Fuentes	Mr. Fuentes has nothing to disclose.
Betsy C. Vazquez, MD	Dr. Vazquez has nothing to disclose.
Jimena Gonzalez Salido, MD	Miss Gonzalez Salido has nothing to disclose.
Jimena Colado, MD	Dr. Colado has nothing to disclose.
Eithel A. Valenzuela Mendivil, MD	Dr. Valenzuela Mendivil has nothing to disclose.
Iris E. Martinez-Juarez, MD (Instituto Nacional de Neurología y Neurocirugía)	No disclosure on file

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