Pronounced microcephaly in a patient with malignant migrating partial seizures in infancy
Andreas Hahn1, Martina Heckel, Bernd A Neubauer
1Department of Neuropediatrics, University of Giessen, Germany. Andreas.Hahn@paediat.med.uni-giessen.de
Abstract:
Malignant migrating partial seizures in infancy is an age-specific epilepsy syndrome, resistant to conventional antiepileptic drugs in most cases. Since the first description of 14 infants in 1995, only 16 additional patients have been reported. We add a further case and present a video that shows a typical generalizing tonic seizure arising from the right temporo-occipital area and slowly spreading about both hemispheres. In addition to other symptoms previously described, almost complete arrest of brain growth with onset of seizures and evolution of distinctive secondary microcephaly were striking features in this patient. [Published with video sequences].
Insights
Malignant migrating partial seizures in infancy is a rare epilepsy syndrome often resistant to standard treatments. This case highlights severe brain growth arrest and microcephaly as key features, adding to the limited patient data.
Area of Science:
- Neurology
- Pediatric Epilepsy
Background:
- Malignant migrating partial seizures in infancy (MMPEI) is a rare, age-specific epilepsy syndrome.
- It is characterized by drug-resistant seizures and typically affects infants.
- Few cases have been reported since its initial description in 1995.
Observation:
- This report details an additional case of MMPEI.
- A video demonstrates a typical generalizing tonic seizure originating from the right temporo-occipital region.
- The seizure slowly spread across both hemispheres.
Findings:
- The patient exhibited previously described MMPEI symptoms.
- Strikingly, the patient showed an almost complete arrest of brain growth coinciding with seizure onset.
- Distinctive secondary microcephaly evolved alongside the seizures.
Implications:
- This case expands the known spectrum of MMPEI.
- It underscores the potential for severe neurodevelopmental consequences, including microcephaly and growth arrest.
- Further research is needed to understand the pathophysiology and develop effective treatments for this severe epilepsy syndrome.
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