Related Experiment Videos
The ontogeny of partial seizures in infants and young children
D R Nordli1, M M Kuroda, L J Hirsch
1Epilepsy Center, Children's Memorial Hospital, Chicago, Illinois, USA. dnordli@childrensmemorial.org
Insights
Pediatric partial seizures show age-dependent clinical changes. Aura, automatisms, and generalization increase with age, while specific posturing decreases, aiding epilepsy classification and treatment.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Neurophysiology
Background:
- Partial seizures in children present unique diagnostic challenges.
- Understanding age-related seizure manifestations is crucial for accurate diagnosis and management.
Purpose of the Study:
- To delineate the clinical and electroencephalographic (EEG) characteristics of partial seizures in pediatric patients across different age groups.
- To identify age-dependent trends in seizure semiology and localization.
Main Methods:
- Retrospective analysis of 123 pediatric patients with partial seizures and EEG correlation.
- Seizure characteristics were categorized by age groups: 0-2, 2-6, and 6+ years.
- Statistical analysis (chi-squared tests for trend) was employed to assess age-related changes.
Main Results:
- Increased frequency of aura, limb automatisms, dystonic posturing, secondary generalization, and unresponsiveness with age.
- Decreased frequency of asymmetric clonus and symmetric tonic posturing with advancing age.
- Tendency for anteriorly originating partial seizures to increase and posteriorly originating seizures to decrease with age, with no significant change in EEG ictal patterns.
Conclusions:
- Significant age-related differences exist in the clinical presentation of pediatric partial seizures.
- Findings enhance understanding of ictal ontogeny, improving seizure and epilepsy classification in young patients.
- This knowledge aids in identifying candidates for epilepsy surgery and selecting optimal anticonvulsant medications.
Purpose:
To describe the clinical manifestations of partial seizures in the pediatric population as a function of age.
Methods:
Using the database of the pediatric epilepsy monitoring unit (Children's Hospital of New York), clinical and EEG characteristics of partial seizures were distributed by age groups 0-2, 2-6, and 6+ years for 123 patients who had at least one such seizure with a clear EEG correlate during their admission. chi2 tests for trend were used to examine clinical and EEG features as a function of age.
Results:
The frequency of aura, limb automatisms, dystonic posturing, secondary generalization, and unresponsiveness increased with age, whereas asymmetric clonus and symmetric tonic posturing decreased with age. There were no clear changes in the types of EEG ictal patterns observed with age; however, partial seizures emanating from the anterior regions of the brain tended to increase with age, whereas those from the posterior regions tended to decrease with age.
Conclusions:
Important differences exist in the clinical expression of seizures between young children and adults. These findings will contribute to a better understanding of ictal ontogeny that will promote more accurate classification of seizures and of the epilepsies in young patients. Such efforts can be used to identify young patients for focal epilepsy surgery and to select appropriate anticonvulsive medications.