Seizures and Epilepsy in Preterm and Term Neonates, Infants, Children, and Adolescents

Abstract

Children are often affected by seizure types and epilepsy syndromes that are specific to their age group and distinct from those seen in adults. At the same time, certain epilepsy syndromes affecting the adult population, such as Lennox–Gastaut syndrome and juvenile myoclonic epilepsy, often begin during childhood, as do seizures related to genetic abnormalities. The use of electroencephalography (EEG) and prolonged EEG monitoring has allowed for further insight and greater specificity in identifying and understanding seizures and epilepsy syndromes in children. This chapter reviews the role of EEG in pediatric seizures and the pediatric epilepsies, including electrographic findings in the ictal state and in the interictal period, as well as the correlation with clinical seizure semiology as it contributes to the diagnosis of epileptic phenomena. The chapter discusses EEG patterns, seizure types, and epilepsy syndromes specific to neonates, infants, children, and adolescents.

The role of EEG in the diagnosis and classification of the epilepsy syndromes: a tool for clinical practice by the ILAE Neurophysiology Task Force (Part 2)

“…In contrast, myoclonic seizures (MS) (axial, segmentary, or erratic) are typical in EME and rare in OS. Subtle seizure with autonomic phenomena, such as flushing or apnoea, can also occur (Yamatogi and Ohtahara, 2002;Beal et al, 2017). Erratic and segmentary myoclonus occur early on, often within the first few days or month of life (Guerrini and Aicardi, 2003).…”

“…Among 38 infants with seizures beginning within the first two months (mean: 0 months), not related to acute symptomatic causes (anoxic-ischaemic encephalopathies, neonatal stroke, metabolic, or infectious), the main seizure types were focal (76%) and epileptic spasms (24%) (Akiyama et al, 2010); 34 of those (89%) had focal seizures and epileptic spasms in combination, with the second seizure type appearing after a median of three months. Typically, the presence of a focal lesion is suggested by stereotyped focal seizures, electrographically arising from the same region (but potentially multifocal in the case of tuberous sclerosis complex), or by asymmetries in voltage or frequency of background activities (Beal et al, 2017), however, interictal EEG can also be normal. While the asymmetry in interictal EEG was often associated with the presence of a structural brain abnormality, the S-B pattern was also associated with cerebral lesions in around half of the patients, as previously reported for OS (see relevant section and Aicardi and Ohtahara [2005], Akiyama et al [2010], and Yamamoto et al [2011]).…”

“…Seizures may be tonic or clonic, or exhibit only subtle motor manifestations or autonomic symptoms, or be sub-clinical, especially when arising from temporal regions (Volpe, 1989;Mizrahi and Kellaway, 1987;Mizrahi and Kellaway, 1998;Beal et al, 2017). Seizures may be tonic or clonic, or exhibit only subtle motor manifestations or autonomic symptoms, or be sub-clinical, especially when arising from temporal regions (Volpe, 1989;Mizrahi and Kellaway, 1987;Mizrahi and Kellaway, 1998;Beal et al, 2017).…”

“…These may be The role of EEG in the diagnosis and classification of the epilepsies motor with deviation of the eyes, tonic posturing, or hemiconvulsions. Subtle seizure with autonomic phenomena, such as flushing or apnoea, can also occur (Yamatogi and Ohtahara, 2002;Beal et al, 2017).…”

“…While the asymmetry in interictal EEG was often associated with the presence of a structural brain abnormality, the S-B pattern was also associated with cerebral lesions in around half of the patients, as previously reported for OS (see relevant section and Aicardi and Ohtahara [2005], Akiyama et al [2010], and Yamamoto et al [2011]). Typically, the presence of a focal lesion is suggested by stereotyped focal seizures, electrographically arising from the same region (but potentially multifocal in the case of tuberous sclerosis complex), or by asymmetries in voltage or frequency of background activities (Beal et al, 2017), however, interictal EEG can also be normal. Although EEG findings can sometimes be fairly characteristic (for instance periodic focal abnormalities in focal cortical dysplasia or cortical tubers Kotulska et al, 2014]), or high-voltage monomorphic theta or delta activity in lissencephaly), precise diagnosis relies on neuroimaging.…”