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A peculiar form of epilepsy induced by crying in infancy

Hitoshi Yamamoto1, Hiroshi Murakami, Noriko Kamiyama

  • 1Department of Pediatrics, St. Marianna University, School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki 216-8511, Kanagawa, Japan. h3yama@marianna-u.ac.jp

Brain & Development
|February 20, 2007
PubMed

Insights

This study identifies a unique epilepsy in infants triggered by crying, often mistaken for breath-holding spells. This benign, age-dependent reflex epilepsy is effectively managed with valproate sodium.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Clinical Neuroscience

Background:

  • Epilepsy in infancy can present with diverse seizure types and triggers.
  • Breath-holding spells are common in infants and can be mistaken for seizures.
  • Reflex epilepsies are characterized by seizures precipitated by specific stimuli.

Observation:

  • Three infants presented with generalized tonic-clonic seizures exclusively following prolonged crying.
  • Seizures were triggered by sudden, unexpected, mildly unpleasant stimuli during crying episodes.
  • Onset occurred between 10 and 18 months in otherwise normally developing infants with normal MRIs.

Findings:

  • Electroencephalogram (EEG) showed focal spikes interictally and generalized spikes ictally.
  • Seizures were brief, typically lasting under 1 minute.
  • Valproate sodium demonstrated excellent seizure control in all patients.

Implications:

  • This condition represents a distinct, benign, age-dependent reflex epilepsy.
  • Accurate diagnosis is crucial to differentiate from breath-holding spells and guide appropriate treatment.
  • Understanding crying-induced epilepsy enhances diagnostic accuracy and therapeutic strategies in pediatric neurology.

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