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[Clinical polymorphism of malignant epilepsy of infancy with migrating multifocal seizures (8 cases)]

A S Petrukhin, A A Kholin, E S Il'ina

    Zhurnal Nevrologii I Psikhiatrii Imeni S.S. Korsakova
    |July 22, 2009
    PubMed

    Insights

    Malignant epilepsy of infancy with migrating multifocal seizures is a rare, severe epilepsy syndrome starting in early infancy. This condition is characterized by frequent, diverse seizures and developmental arrest, often proving resistant to standard treatments.

    Area of Science:

    • Neurology
    • Pediatric Neurology
    • Epileptology

    Background:

    • Malignant migrating partial seizures in infancy (MMPSI) is a rare epilepsy syndrome.
    • It begins within the first six months of life.
    • Characterized by continuous electroencephalographic (EEG) and electroclinical focal ictal patterns involving independent areas of both hemispheres, leading to psychomotor development arrest.

    Observation:

    • This review details observations of 8 newly diagnosed patients at a Moscow hospital.
    • All patients exhibited at least three distinct ictal patterns from independent hemispheric areas via video-EEG monitoring.
    • High seizure polymorphism (≥5 types per child) and frequency were noted.

    Findings:

    • The observed cases were largely pharmacoresistant to antiepileptic therapies.
    • Progressive deterioration occurred in 50% of patients.
    • A combination of valproates, benzodiazepines, and barbiturates reduced seizure frequency by 50% in 37.5% of patients; valproates, benzodiazepines, and levetyracetam achieved 75% reduction in one case.

    Implications:

    • The study proposes a definition: "malignant epilepsy of infancy with migrating multifocal seizures".
    • Highlights the need for specialized treatment approaches for this severe infantile epilepsy.
    • Emphasizes the challenges in managing pharmacoresistant epilepsy in infants and the potential role of specific drug combinations.

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