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Published on: September 20, 2024
[Clinical observation and long-term follow-up of benign infantile epilepsy]
Xiao-yan Liu1, Yu-wu Jiang, Ju Wu
1Department of Pediatrics, First Hospital, Beijing University, Beijing 100034, China.
Insights
Benign infantile epilepsy presents with specific seizure patterns and normal development in infants. Early diagnosis and treatment lead to seizure freedom within a year.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Neuroscience
Context:
- Benign infantile epilepsy (BIE) is a distinct epilepsy syndrome in infants.
- Accurate early diagnosis is crucial for appropriate management and prognosis.
- Distinguishing BIE from other epilepsy syndromes is essential.
Purpose:
- To investigate the clinical characteristics, electroencephalogram (EEG) changes, and therapeutic responses in infants with BIE.
- To identify early diagnostic markers for BIE.
- To evaluate the long-term outcomes of BIE.
Summary:
- Forty-two infants diagnosed with BIE showed characteristic seizure patterns, including clusters and partial seizures, with normal development and EEG background.
- Video-EEG monitoring aided in localizing seizure origins.
- All treated patients achieved seizure freedom within one year with single antiepileptic drugs.
Impact:
- This study refines diagnostic criteria for benign infantile epilepsy.
- Highlights the importance of early recognition for favorable outcomes.
- Provides insights into EEG findings and treatment efficacy in BIE.
Objective:
To investigate clinical characteristics, EEG changes and therapeutic response of benign infantile epilepsy and to study the early diagnostic methods.
Methods:
Clinical observation and Video-EEG monitoring were carried out in babies with convulsions at 3 - 24 months of age. In these children, febrile convulsion, symptomatic epilepsies and developmental abnormalities were excluded, and the therapeutic effect and long-term outcome were followed up.
Results:
Forty-two babies were diagnosed to have benign infantile epilepsy by two-year follow-up. Three of them had familial history of benign infantile convulsions. Nineteen percent had mild diarrhea during the onset of convulsions, cluster seizures occurred during a short period in 67% of cases and no status epilepticus occurred. Video-EEG monitoring confirmed seizures originating from temporal, occipital or multifocal areas separately in 3 patients with partial seizures. Interictal EEG background was normal and there were Rolandic small spikes during sleep in 24% of patients. Thirty-nine patients were treated with single antiepileptic drugs and the mean treatment course was 9 months. Three cases did not take medicine. All the patients were seizure free within a year.
Conclusion:
Benign infantile epilepsy should be considered when the following characteristics occur in early stage of the disease: (1) convulsions occurring between 3 to 12 month of age and not later than 24 months of age with or without familial history of benign infantile convulsion; (2) normal psychomotor development before and after convulsion occurs; (3) no evoked factors or only mild diarrhea; (4) majority of cases have partial seizures, or secondary generalized seizures. There are often cluster convulsions during the onset stage, but no status epilepticus; (5) normal EEG background and there may be Rolandic small spikes during sleep; (6) normal neuroimaging.
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