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Migrating focal seizures during infancy: a case report and pathologic study

Lorena Fasulo1, Silvia Saucedo, Lidia Cáceres

  • 1Department of Neuropediatrics, Prof. Dr. A. Posadas Hospital, Buenos Aires, Argentina. lorena.fasulo@hiba.org.ar

Pediatric Neurology
|February 23, 2012
PubMed

Insights

Migrating focal seizures in infancy, a rare epilepsy syndrome, present with continuous seizures and developmental arrest. Potassium bromide showed efficacy but did not prevent severe impairment or death in one infant case.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Developmental Neuroscience

Background:

  • Migrating focal seizures in infancy is a rare epilepsy syndrome characterized by early onset (before 6 months), continuous seizures affecting multiple brain areas, and psychomotor development arrest.
  • This condition is often overlooked and presents diagnostic and therapeutic challenges.

Observation:

  • A case of a 45-day-old infant with migrating focal seizures is presented.
  • Seizures were refractory to standard antiepileptic drugs.
  • The infant developed severe neurological impairment, including axial hypotonia and lack of visual contact and head control.

Findings:

  • Potassium bromide treatment at 6 months led to near seizure freedom.
  • Despite seizure control, the infant experienced severe neurological deficits.
  • The infant died at 8 months of age.
  • Post-mortem examination revealed cortical malformations, polymicrogyria, focal cortical dysplasia, and hippocampal sclerosis.

Implications:

  • This case highlights the severe prognosis of migrating focal seizures in infancy, even with apparent seizure control.
  • It underscores the importance of early diagnosis and aggressive management strategies for this epilepsy syndrome.
  • The pathological findings suggest underlying cortical malformations contribute significantly to the severe neurological outcomes.

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