Migrating partial seizures in infancy: two new cases

J M Wilmshurst1, D B Appleton, P J Grattan-Smith

  • 1Neurology Department, The New Children's Hospital, Sydney, Australia.

Insights

Migrating partial seizures in infancy are a rare, severe epilepsy syndrome. This study describes two infants with this condition, highlighting their intractable seizures and poor outcomes.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Clinical Neuroscience

Background:

  • Intractable partial seizures in infants pose significant diagnostic and therapeutic challenges.
  • Early-onset epilepsy syndromes require precise characterization for appropriate management.
  • The syndrome of migrating partial seizures in infancy (MPSI) is a rare, severe condition.

Observation:

  • Two infants presented with intractable partial seizures originating from multiple brain regions.
  • Seizures were resistant to all antiepileptic drug therapies.
  • No developmental progress was observed after seizure onset.

Findings:

  • Both infants exhibited multifocal epileptiform activity on electroencephalograms.
  • The clinical presentation and EEG findings met the diagnostic criteria for MPSI.
  • Postmortem examination in one infant revealed no hippocampal sclerosis.

Implications:

  • This case study underscores the diagnostic criteria and clinical course of MPSI.
  • Further research is needed to understand the etiology and pathophysiology of MPSI.
  • Improved diagnostic and therapeutic strategies are crucial for infants with MPSI.

Related Concept Videos

Epilepsy and Seizures: Overview01:24

Epilepsy and Seizures: Overview

Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Seizures: Classification01:13

Seizures: Classification

Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Seizures l: Introduction01:20

Seizures l: Introduction

Understanding seizures and epilepsy relies on key definitions that help in recognizing, classifying, and managing these disorders. These definitions provide a framework for recognizing, classifying, and managing seizure disorders.DefinitionsA seizure is a sudden, abnormal burst of electrical activity in the brain that can cause changes in awareness, movement, sensation, or behavior, depending on the area involved. Epilepsy is a chronic condition characterized by recurrent, unprovoked seizures,...
Seizures ll: Types01:19

Seizures ll: Types

Seizures are sudden bursts of abnormal electrical discharge in the brain that interfere with normal function. They are commonly divided into three groups: focal seizures, generalized seizures, and other types that do not fit neatly into either category.Focal SeizuresFocal seizures begin in a single brain region. When awareness is preserved, they are called focal aware seizures and may cause sensations such as tingling, unusual smells, or flashing lights. When awareness is impaired, they are...
Epilepsy ll: Types01:22

Epilepsy ll: Types

Recurrent seizures, stemming from abnormal electrical activity in the brain, are the defining characteristic of epilepsy, a chronic neurological condition. Because seizure features vary greatly, epilepsy is classified using two systems: by seizure type and by epilepsy syndromes. These classifications enable clinicians to describe seizure patterns and select suitable treatment strategies.I. Classification by Seizure Type1. Focal EpilepsyFocal epilepsy begins in one hemisphere of the brain.