A CASE CONTROL STUDY-TO IDENTIFY PROGNOSTIC VALUE OF EEG & TO DETERMINE ADEQUACY OF SEIZURE CONTROL OF ANTIEPILEPTIC DRUGS(AED) IN CHILDREN WITH ABNORMAL EEG IN A COHORT OF SELFLIMITING EPILEPSY SYNDROMES (SELES)

Background: Self-limiting epilepsy syndromes (SeLES), including self-limited epilepsy with centrotemporal spikes (SeLECTS), self-limited epilepsy with autonomic seizures (SeLEAS), and childhood occipital visual epilepsy (COVE), are common pediatric epilepsies with favorable prognoses. However, the prognostic signicance of electroencephalogram (EEG) abnormalities and optimal antiepileptic drug (AED) therapy strategies for seizure control and neurodevelopmental outcomes remain poorly dened. Methods: This 18-month case-control study at Guru Gobindsingh Government Hospital, Jamnagar, enrolled 100 children aged 3 months to 12 years with SeLES. Cases (n=50) with abnormal EEGs and controls (n=50) with normal EEGs before AED initiation were compared. Data on demographics, EEG patterns (focal vs. generalized discharges), seizure frequency, AED response, and cognitive/behavioral outcomes were collected retrospectively and prospectively. Chi-square tests and multivariate logistic regression assessed associations between EEG ndings and unprovoked/breakthrough seizures after three months of AED therapy (p<0.05). Results: Abnormal EEGs signicantly predicted higher seizure recurrence risk (odds ratio: 2.3, p=0.02), with generalized discharges linked to a 30% relapse rate compared to 10% for focal discharges. Seizure freedom was achieved in 85% of patients, with levetiracetam effective in 90% of SeLECTS cases. SeLEAS showed longer seizure-free intervals (mean: 18 months) than COVE (12 months). Cognitive decits, primarily attention and verbal memory, affected 15% of cases with persistent interictal epileptiform discharges, while 10% exhibited behavioral issues (e.g., anxiety, ADHD), particularly in SeLEAS. Conclusion: EEG abnormalities, particularly generalized discharges, predict seizure recurrence in SeLES, guiding AED selection and duration. Subtype-specic strategies are crucial for optimizing outcomes and minimizing neurodevelopmental impacts.