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Ictal EEG in benign partial epilepsy in infancy
Akihisa Okumura1, Kazuyoshi Watanabe, Tamiko Negoro
1Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan. okumura@med.juntendo.ac.jp <okumura@med.juntendo.ac.jp>
Insights
This study clarifies electroencephalographic findings in benign partial epilepsy in infancy. Seizures consistently began focally, with temporal origins common in complex partial seizures, suggesting a homogeneous condition.
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
Background:
- Benign partial epilepsy in infancy (BPEI) is a childhood epilepsy syndrome.
- Understanding its neurophysiologic features is crucial for diagnosis and management.
Purpose of the Study:
- To elucidate the ictal electroencephalographic (EEG) characteristics of BPEI.
- To correlate EEG findings with seizure manifestations and determine neurophysiologic homogeneity.
Main Methods:
- Retrospective analysis of ictal EEG recordings from 13 infants diagnosed with BPEI.
- Correlation of EEG data with video recordings or clinical observations of seizure manifestations.
- Confirmation of BPEI benignity at or after 8 years of age.
Main Results:
- All seizures exhibited focal onset ictal discharges.
- Temporal lobe origin was noted in 10/13 complex partial seizures.
- Secondarily generalized seizures predominantly originated from parietal or occipital areas.
- Motion arrest or decreased responsiveness was a universal finding.
- Lateral eye deviation was common in complex partial seizures; head rotation indicated hemispheric spread.
Conclusions:
- Ictal EEG findings in BPEI are relatively uniform.
- These findings support the concept of neurophysiologic homogeneity in BPEI.
- Specific EEG patterns correlate with seizure types and propagation.
Abstract:
The aim of this study is to further clarify ictal electroencephalographic findings of patients with benign partial epilepsy in infancy in order to better understand its neurophysiologic features. The study group consisted of 13 infants with definite benign partial epilepsy in infancy, in whom ictal electroencephalograms were recorded and its benignity was confirmed at 8 years or more. The seizure manifestation was reviewed on the basis of video findings in eight patients in whom simultaneous video-electroencephalography recording was available. In the other five patients, the seizure manifestations were determined according to the observations of physicians, nurses, or technicians. Thirteen seizures from eight patients were complex partial, and six seizures from six patients were secondarily generalized ones. Ictal discharges at the onset of a seizure were focal in all seizures. The site of the origin of seizures was in the temporal area in 10 of 13 complex partial seizures, whereas it was in the parietal or occipital area in all 6 secondarily generalized seizures. Among 13 complex partial seizures, paroxysmal discharges remained focal throughout the seizures in 6 seizures, whereas they spread to one hemisphere in the other 7 seizures. Motion arrest or decreased responsiveness was uniformly observed. Lateral eye deviation was commonly recognized in complex partial seizures, whereas head rotation was observed only in seizures in which hemispheric propagation of ictal discharges was observed. Ictal electroencephalographic findings of patients with benign partial epilepsy in infancy were relatively uniform, suggesting the homogeneity of patients with benign partial epilepsy in infancy.
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