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Benign partial epilepsies in infancy
1Department of Pediatrics, Nagoya University School of Medicine, 65 Tsurumai, Showa-ku, 466, Nagoya, Japan. kwatana@med.nagoya-u.ac.jp
Insights
Benign partial epilepsies in infants, including those with complex partial seizures (CPS) and secondarily generalized seizures (SGS), are often underdiagnosed due to subtle symptoms. Recognizing their distinct origins and characteristics is crucial for accurate diagnosis and management.
Area of Science:
- Neurology
- Pediatric Neurology
- Epileptology
Background:
- Benign partial epilepsies are common in infants, presenting as two related forms: complex partial seizures (CPS) and secondarily generalized seizures (SGS).
- Partial epilepsy with CPS is often overlooked due to subtle seizure manifestations and a favorable prognosis.
- Benign infantile convulsions frequently represent partial epilepsy with SGS, necessitating ictal EEG confirmation.
Purpose of the Study:
- To highlight the distinct characteristics of benign partial epilepsies in infants.
- To emphasize the diagnostic challenges associated with partial epilepsy and CPS.
- To underscore the importance of recognizing these conditions for accurate diagnosis.
Main Methods:
- Review of clinical presentations and seizure origins in infantile epilepsies.
- Comparison of seizure characteristics between CPS and SGS forms.
- Discussion of diagnostic criteria and inheritance patterns.
Main Results:
- Seizure origin differs: temporal for CPS, central/parietal/occipital for SGS.
- Partial epilepsy with CPS has subtle manifestations, leading to underdiagnosis.
- Many benign infantile convulsions may be partial epilepsy with SGS, requiring EEG confirmation.
- Familial cases suggest both autosomal dominant and recessive inheritance patterns.
Conclusions:
- Accurate diagnosis of benign partial epilepsies, particularly the CPS form, requires awareness of their subtle features.
- Understanding seizure origin and clinical characteristics aids in differentiating infantile epilepsy subtypes.
- Further research into genetic patterns of infantile epilepsy is warranted.
Abstract:
Benign partial epilepsies are not rare in infancy and comprise two forms, although both are closely related. One is partial epilepsy with complex partial seizures (CPS) and the other one with secondarily generalized seizures (SGS). The most frequent site of seizure origin was in the temporal area in the former and central, parietal or occipital area in the latter. The former has not been well recognized because of subtle seizure manifestations and a favorable outcome. Its unique characteristics should be emphasized because it may be difficult to diagnose it unless we know its presence. Benign convulsions are also common in infancy. Most of them may belong to partial epilepsy with SGS, although confirmation with ictal EEG recording is necessary for accurate diagnosis. Some are familial and many of them seem to show an autosomal dominant pattern, but some seem to have autosomal recessive inheritance.