Peri-ictal lateralizing signs in children: blinded multiobserver study of 100 children < or =12 years

Area of Science:

• Pediatric Neurology
• Epileptology

Background:

• Partial epilepsy affects numerous children, with temporal lobe epilepsy being a common subtype.
• Accurate localization of seizure onset is crucial for effective treatment and presurgical planning.

Purpose of the Study:

• To assess the reliability and predictive value of lateralizing signs (LSs) in children with partial epilepsy.
• To determine the influence of age on the occurrence and utility of LSs.
• To evaluate the potential of LSs in the presurgical evaluation of pediatric epilepsy.

Main Methods:

• Observational study involving 100 children diagnosed with partial epilepsy.
• Systematic assessment of lateralizing signs by multiple independent observers.
• Analysis of interobserver agreement and predictive value of identified LSs.
• Correlation of LS occurrence with patient age.

Main Results:

• Seventy-five percent of children exhibited observable LSs.
• Most LSs demonstrated high interobserver agreement and strong predictive value.
• Age influenced the frequency of certain LSs, with younger children showing fewer LSs and older children exhibiting specific signs more frequently.
• Several reliable LSs were found to be age-independent.

Conclusions:

• Lateralizing signs are valuable tools in the neurological assessment of children with partial epilepsy.
• LSs possess high reliability and predictive accuracy, aiding in seizure localization.
• The findings support the use of LSs in the presurgical evaluation of pediatric epilepsy, including infants and young children.