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Benign convulsions in newborns and infants: occurrence, clinical course and prognosis
A Hrastovec1, T Hostnik, D Neubauer
1Medical Faculty, University of Ljubljana, Slovenia.
Insights
Benign neonatal and infantile convulsions are more common than severe epilepsies. Most children with these benign conditions, including benign myoclonus and benign partial epilepsy, show normal development, with males being more frequently affected.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Epileptology
Background:
- Severe epilepsies can manifest in early development, alongside benign non-epileptic and epileptic syndromes with favorable prognoses.
- Exact incidence data for these benign infantile paroxysmal syndromes are lacking.
Purpose of the Study:
- To evaluate the occurrence, clinical characteristics, and prognosis of benign non-epileptic and epileptic events in infants.
- Specifically reviewed benign myoclonus of early infancy, benign neonatal sleep myoclonus, benign sleep myoclonus in infancy, benign partial epilepsy in infancy (BPEI), and benign infantile familial convulsions (BIFC).
Main Methods:
- Retrospective analysis of 31 children meeting inclusion criteria.
- Included clinical data, laboratory values, neuroimaging, and neurophysiological assessments.
- Psychosocial development evaluated using the Strengths and Difficulties Questionnaire (SDQ).
Main Results:
- Incidence: benign non-epileptic convulsions (6.69/10,000 live births), benign epileptic convulsions (1.35/10,000).
- Male predominance in non-epileptic events (2.1:1 ratio).
- Most children showed normal or nonspecific findings in neurological, laboratory, neurophysiological, and neuroimaging assessments; psychosocial development was largely unaffected, except for peer relations.
Conclusions:
- Benign neonatal and infantile convulsions are more frequent than severe epilepsies in this age group.
- Higher proportion of males observed in benign non-epileptic conditions.
- No significant long-term developmental deviations were identified in children with these benign syndromes.
Background:
During early development severe epilepsies may appear, some with well established occurrence. Benign non-epileptic and epileptic paroxysmal syndromes with excellent prognosis occur in the same period. There are no exact data on their occurrence.
Aim:
We have reviewed medical histories of children with benign non-epileptic or benign epileptic events: benign myoclonus of early infancy, benign neonatal sleep myoclonus, benign sleep myoclonus in infancy, benign partial epilepsy in infancy (BPEI) and benign infantile familial convulsions (BIFC) were established. The occurrence, clinical characteristics and prognosis of these syndromes were evaluated.
Methods:
Inclusion criteria were met in 31 children. Research included retrospective analysis of clinical characteristics, laboratory values, neuroimaging and neurophysiological assessments, followed by evaluation of psychosocial development with the use of the Strengths and Difficulties Questionnaire (SDQ), fulfilled by parents.
Results:
In our group the incidence of benign non-epileptic convulsions was 6.69 per 10 000 live births and the incidence of benign epileptic convulsions was 1.35 per 10 000. Male/female ratio in the group of children with non-epileptic events was 2.1:1. Among non-epileptic group 5 out of 23 children and among epileptic group 3 out of 8 children had minimal, mild or moderate abnormalities at neurological assessment at the time of the first clinical examination. Nonspecific changes in laboratory values were seen in 6 out of 23 in the non-epileptic and in 1 out of 8 children in the epileptic group. Neurophysiological assessments showed subtle changes in 4/23 in the non-epileptic and 6/8 in the epileptic group. Neuroimaging was not optimal in 5/23 with non-epileptic and 3/8 with epileptic events. Analysis of SDQ did not show significant deviations in psyhosocial development. Statistically significant deviation was observed only in relations with peers (p = 0.009).
Conclusions:
Benign neonatal and infantile convulsions are more frequent than severe epilepsies of the same age period. Results show higher proportion of males with benign non-epileptic conditions. No deviations in further development was found. Laboratory values, neuroimaging and neurophysiological assessments were normal or nonspecifically changed.
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