Related Experiment Video

Updated: Aug 22, 2026

Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy
09:57

Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy

Published on: September 20, 2024

Lateralizing signs during seizures in infants

Tobias Loddenkemper1, Elaine Wyllie, Silvia Neme

  • 1Department of Pediatric Medicine, Children's Hospital, Cleveland Clinic Foundation, 9500 Euclid Ave, 44195, Cleveland, OH, USA. loddent@ccf.org

Journal of Neurology
|September 17, 2004
PubMed

Insights

Focal clonic activity and unilateral spasms reliably indicate seizure origin in infants. Other signs like tonic eye version were unreliable for lateralizing seizure onset.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Clinical Neurophysiology

Background:

  • Identifying seizure onset is crucial for epilepsy management in infants.
  • Lateralizing signs during seizures can help localize the epileptogenic zone.
  • Infantile epilepsy presents unique diagnostic challenges due to immature neurological systems.

Purpose of the Study:

  • To identify reliable lateralizing features during seizures in infants.
  • To assess the diagnostic accuracy of observed semiological signs for seizure lateralization.

Main Methods:

  • Video-electroencephalography (EEG) monitoring of infants post-epilepsy surgery.
  • Blinded video review to classify lateralizing signs and seizure semiology.
  • Analysis of 100 seizures from 19 infants aged 1-32 months.

Main Results:

  • Unilateral clonic jerking and predominantly unilateral infantile spasms were reliable lateralizing signs.
  • Focal tonic activity, nystagmus, and postictal hemiparesis were also contralateral but less frequent.
  • Tonic eye version proved unreliable for lateralizing seizure onset in this cohort.

Conclusions:

  • Focal clonic activity and unilateral spasms are dependable indicators of seizure lateralization in infants.
  • Certain signs like tonic eye version are not consistently reliable for pinpointing seizure origin.
  • Findings aid in refining the interpretation of seizure semiology for improved localization in pediatric epilepsy.
Abstract

More Related Videos

Continuous Video Electroencephalogram during Hypoxia-Ischemia in Neonatal Mice09:29

Continuous Video Electroencephalogram during Hypoxia-Ischemia in Neonatal Mice

Published on: June 11, 2020

Application of an Amplitude-integrated EEG Monitor (Cerebral Function Monitor) to Neonates05:58

Application of an Amplitude-integrated EEG Monitor (Cerebral Function Monitor) to Neonates

Published on: September 6, 2017

Related Concept Videos

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...
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: 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:
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.
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...