[Clinical aspects of epilepsy in children with periventricular leukomalacia]

We investigated the frequency and characteristics of epilepsy in 63 children (39 males and 24 females) with cerebral palsy caused by periventricular leukomalacia, who were born preterm at <34 weeks' gestation and followed for more than five years (duration: 5-18 years, mean: 9.6 years). While seven (11%) of the 63 patients had febrile convulsions (FC), 11 (17%) were associated with symptomatic localization-related epilepsy (SLRE) and 8 (13%) with West syndrome (WS). The gestational ages of the WS group were significantly (p<0.05) longer than in FC group. The DQ of the SLRE and WS groups were significantly (p<0.01) lower than in the N-S group. The frequency of spastic quadriplegia was 19%, 29%, 36%, 50% in the N-S, FC, SLRE, WS groups, respectively. Among the 11 SLER patients, 5 had one seizure type, while 3 had two and 3 had three seizure types. The seizure patterns included complex partial seizures (CPS) in 8, secondarily generalized partial epileptic seizures in 8, and simple partial seizures in 4. One patients in the WS group developed CPS, and another patient developed epilepsy undetermined after infancy. Regarding the main localizing symptoms of SLRE, oculogyric seizures were observed in 7 patients and hemi-facial seizures were observed in 8 patients. In all WS patients, the location of the epileptiform discharges was in the parieto-occipital area, while 8 of 11 patients with SLES had it in the central area.

30% of all patients with PVL were associated with epilepsy. WS developed in 13% during early infancy and SLRE developed in 17% after infancy. The most common epileptic seizure in the patients with PVL was complex partial seizure.