Complex Partial Seizures of Infancy

Duchowny, Michael

doi:10.1001/archneur.1987.00520210013011

Cited by 72 publications

(42 citation statements)

References 20 publications

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“…These findings, the high incidence of automatisms and age-related features, are in accord with those of other studies of younger patients with CPS in which video-EEG monitoring was used (Holmes, 1986;Duchowny, 1987; Yamamoto et a]., 1987). We noted dystonic posturing of one limb in 2 infants and 3 older children.…”

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confidence: 90%

Complex Partial Seizures in Young Children

Bye

Foo

1994

Epilepsia

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We retrospectively analyzed the clinical manifestations of complex partial seizures (CPS) in children aged < or = 10 years using video and EEG telemetry and evaluated their course, investigations, management, and seizure status at follow-up. Seventeen patients with CPS were studied at the Prince of Wales Children's Hospital (POWCH) and Prince Henry Hospital (PHH) between 1987 and 1992. Because 15 of the 17 patients had intractable seizures, the population was selective. Mean age was 6.5 years; 4 patients were aged < or = 2 years. Clinical features were normal or mild intellectual handicap (13); hemiplegia (5); and infantile spasms preceding CPS (4); of these, 2 also had simple partial motor seizures. Structural abnormalities were noted on scanning in 9 patients. Eighty-seven seizures were reviewed. Mean duration of each clinical seizure was 59.7 s (total population), 108 s (subgroup 1, aged < or = 2 years), and 48.5 s (subgroup 2, aged > 2 years). Major ictal manifestations were auras (9), staring (9), autonomic changes (6), and automatisms (17). In subgroup 1, automatisms were simple and mainly oroalimentary and gestural. Two patients had no change in surface ictal recordings, and 2 had normal interictal EEGs. At follow-up, 8 patients were seizure-free for 6 months, 1 was partially controlled (more than two seizures a month), and 8 had intractable seizures (two or more seizures a month). Seven patients underwent operation for intractable epilepsy, and 4 achieved a class 1A outcome (Engel classification).

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confidence: 90%

Complex Partial Seizures in Young Children

Bye

Foo

1994

Epilepsia

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“…For example, patients with severe myoclonic epilepsy do not exhibit myoclonus or spike wave activity until the 2nd or 3rd year of life 1314 Identifying localisation related (focal) epilepsy is also most difficult in the 1st year of life in the absence of any structural brain lesion disclosed by neuroradiology 1516 …”

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Diagnosing idiopathic/cryptogenic epilepsy syndromes in infancy

Sarisjulis

Gamboni²,

Plouin³

et al. 2000

Archives of Disease in Childhood

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Purpose-To determine the characteristics that permit diagnosis of the type of epilepsy beginning in the 1st year of life, and to determine from what age such characteristics are recognisable. Patients-From 430 non-selected patients who began having seizures in the 1st year of life and were referred to the neuropaediatric department of Saint Vincent de Paul Hospital, those with epileptic spasms as the first seizure type, those with recognisable aetiology, and those for whom early history was not reliable were excluded. Methods-For the remaining 140 patients, the age at which clinical and electroencephalogram (EEG) characteristics met those of recognisable epilepsy syndromes according to the ILAE classification was studied. Results-In most epilepsy syndromes, the diagnosis could be made within three months of onset of the disorder. The most diYcult was to distinguish cryptogenic localisation related epilepsy from severe myoclonic epilepsy in infancy. Repeat focal seizures and persisting spike focus were the earliest and most reliable signs of localisation related epilepsy, whereas alternating focal seizures, generalised myoclonus, and/or spike waves appeared before the end of the 1st year in most infants with severe myoclonic epilepsy. However, for 39 patients it was not possible to reach the diagnosis of a precise syndrome. Conclusion-For over three quarters of infants with cryptogenic/idiopathic epilepsy, it is possible to reach a syndromic diagnosis within the first months of the disease, based on clinical and EEG characteristics. However, for one quarter, no diagnosis is possible based on the currently available classification. (Arch Dis Child 2000;82:226-230)

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“…Como salientado em outros estudos [5][6][7]14,15 , a história fornecida pelos pais sobre as manifestações clínicas dos eventos paroxísticos, nesta faixa etária, é confusa e pouco elucidativa. Neste contexto, o vídeo-EEG passa a desempenhar um importante papel na elucidação diagnóstica e conduta terapêutica dos eventos paroxísticos da infância.…”

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O vídeo-EEG dia no diagnóstico de eventos paroxísticos na infância

Freitas¹,

Fiore²,

Gronich³

et al. 2003

J. Pediatr. (Rio J.)

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ResumoObjetivo: este estudo tem como objetivo investigar o valor do vídeo-EEG dia numa população pediátrica, com queixas clínicas diversas, verificando os benefícios e as limitações deste método.Casuística e métodos: um protocolo prospectivo, desenvolvido na Universidade de São Paulo, analisou 38 pacientes consecutivos (quatro meses a 17 anos; média 6,9 anos). Todos os pacientes foram encaminhados para elucidação do seu quadro clínico. Estes foram classificados, segundo sua queixa clínica principal, em: dúvidas sobre a classificação das crises/ síndromes epilépticas em 22 pacientes (grupo I); diagnóstico diferencial entre eventos epilépticos e não epilépticos em 8 (grupo II); e diagnóstico diferencial entre declínio cognitivo e estado de mal epiléptico (EME) não convulsivo em 8 pacientes (grupo III).Resultados: episódios clínicos foram registrados em 36 pacientes (94,7%). No grupo I, as crises epilépticas foram reclassificadas em 11/22 (50%) pacientes e confirmadas em oito (36,4%). Deste grupo, um paciente apresentou distúrbio do sono, e dois não apresentaram eventos clínicos durante a monitorização. A classificação sindrômica foi modificada em nove pacientes (40,9%). No grupo II, quatro pacientes (50%) apresentaram eventos epilépticos. A deterioração cognitiva estava associada com EME em cinco crianças (62,5%) do grupo III. Mudanças na conduta terapêutica e diagnós-tica, como conseqüência da monitorização, ocorreram em 21/38 (55,3%) pacientes.Conclusão: em nossa série, o vídeo-EEG dia estabeleceu o diagnóstico na maioria dos pacientes, relacionando os dados clínicos com os eletrencefalográficos. Este procedimento foi bem tolerado pelas crianças, incluindo lactentes e aquelas com doenças psiquiátri-cas.J Pediatr (Rio J) 2003;79(3):259-64: epilepsia, monitorização, classificação. AbstractObjective: the objective of this study was to investigate the value of short-term video-EEG monitoring in a pediatric population with distinct clinical complaints in order to verify the benefits and limitations of this procedure.Patients and methods: a prospective protocol, developed in the University of São Paulo, analyzed 38 consecutive patients (age ranging from 4 months to 17 years; mean 6.9 years). All patients were referred in order to establish the diagnosis. The patients were divided in the following groups according to the main clinical complaint: doubts about seizure/syndromic classification (Group I, n = 22); differential diagnosis with non-epileptic events (Group II, n = 8) and differential diagnosis between cognitive decline and status epilepticus (Group III, n = 8).Results: clinical episodes were observed in 36 patients (94.7%). In group I, seizures were reclassified in 11/22 (50%) patients and confirmed in eight (36.4%). One patient presented a sleep disorder and two did not present clinical events during monitoring. Syndromic classification was modified in nine (40.9%). In group II, four patients (50%) presented epileptic seizures; two had movement disorders and two, non-epileptic events. The cognitive deteriorati...

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Complex Partial Seizures of Infancy

Cited by 72 publications

References 20 publications

Complex Partial Seizures in Young Children

Complex Partial Seizures in Young Children

Diagnosing idiopathic/cryptogenic epilepsy syndromes in infancy

O vídeo-EEG dia no diagnóstico de eventos paroxísticos na infância

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