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[Epilepsy in severely handicapped children]
1Division of Pediatric Neurology, Central Hospital, Aichi Prefectural Colony, Kasugai.
Insights
Epilepsy in severely handicapped children often presents as infantile spasms or partial seizures. Lennox-Gastaut syndrome (LGS) is a common outcome, developing in over 60% of these children.
Area of Science:
- Neurology
- Pediatrics
- Clinical Neurophysiology
Context:
- Epilepsy in children with severe physical and mental handicaps presents unique diagnostic and management challenges.
- Simultaneous electroencephalography (EEG) and video-tape recording (VTR) monitoring is crucial for characterizing seizure activity in this population.
Purpose:
- To elucidate the specific characteristics of epilepsy in severely handicapped children.
- To classify seizure types and epilepsy syndromes in this cohort.
- To determine the prevalence and progression to Lennox-Gastaut syndrome (LGS).
Summary:
- A study of 56 severely handicapped children documented seizure types including infantile spasms (30.4%) and secondary generalized partial seizures (19.6%).
- Epilepsy syndromes identified were West syndrome (48.1%) and partial epilepsy (23.2%).
- Lennox-Gastaut syndrome (LGS) developed in a significant majority (60.7%) of these children, particularly those initially diagnosed with West syndrome.
Impact:
- Findings highlight the high incidence of LGS in severely handicapped children with epilepsy.
- This research underscores the importance of long-term monitoring and management strategies for epilepsy in this vulnerable population.
- Provides critical data for understanding epilepsy progression and optimizing care for children with complex disabilities.
Abstract:
Clinical and electroencephalographic studies were performed to elucidate the characteristics of epilepsy in severely handicapped children. The subjects were 56 severely mentally and physically handicapped children whose ictal seizures were documented by simultaneous EEG-VTR monitoring. Seizure types were infantile spasms in 17 (30.4%), atypical absence in 5 (8.9%), myoclonic seizures in 3 (5.4%), generalized tonic-clonic seizures in 2 (3.6%), secondary generalized partial seizures in 11 (19.6%), and undetermined in 4 (7.1%). Epilepsy types were also classified by the ictal seizure types and clinical courses: West syndrome in 27 (48.1%), Lennox-Gastaut syndrome (LGS) (at onset) in 5 (8.9%), partial epilepsy in 13 (23.2%) and others (at onset) in 11 (19.8%). Among 29 cases with West syndrome, 22 (81%) developed LGS, and among 11 cases with others group, 64% developed LGS. After all, LGS appeared in 60.7% of all 56 severe epileptic children associated with severe physical and mental handicaps.