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Epilepsy with typical absence seizures with onset during the first year of life
G B Cavazzuti1, F Ferrari, V Galli
1Institute of Pediatrics and Neonatal Medicine, Modena University, Italy.
Insights
Early-onset absence epilepsy in infants presents with typical and complex seizures. Nitrazepam therapy effectively controlled seizures, leading to normal development in a young child.
Area of Science:
- Neurology
- Pediatric Neurology
- Epileptology
Background:
- Absence epilepsy is a type of generalized epilepsy characterized by brief episodes of impaired consciousness.
- While typically diagnosed in childhood, early-onset absence epilepsy beginning in infancy is less common and requires careful characterization.
Observation:
- A case study of a healthy female infant diagnosed with absence epilepsy at 6.5 months of age.
- The infant experienced frequent typical and complex absence seizures, including vacant staring, motor interruptions, and specific facial/postural movements.
- Electroencephalogram-video (EEG-video) monitoring showed characteristic bilateral symmetrical 3-Hz spike-wave discharges associated with the seizures.
Findings:
- The EEG findings included 3-Hz spike-wave discharges, preceded or followed by bilateral frontoparietal theta activity, correlating with seizure onset and cessation.
- The infant's absence seizures showed a significant positive response to nitrazepam treatment.
- The child achieved complete seizure freedom and maintained normal neurological development by age 3 years.
Implications:
- This case highlights the possibility of early-onset absence epilepsy in healthy infants.
- Effective management with nitrazepam can lead to favorable long-term outcomes, including seizure remission and normal development.
- Early diagnosis and prompt treatment are crucial for managing pediatric absence epilepsy and preventing potential developmental impacts.
Abstract:
Absence epilepsy with multiple daily seizures and onset at the age of 6 and 1/2 months in a healthy female child with normal development is described. EEG-video recording revealed typical absence seizures (vacant staring and interruption of motor activity) and complex absences (as above, plus raising of the eyeballs, slight beatings of the eyebrows, and forward propulsion of head and shoulders). The absences were accompanied by bilateral symmetrical 3-Hz spike-wave discharges preceded, and at times followed, by bilateral frontoparietal theta activity coinciding with onset and termination of the absence seizures. The seizures regressed with nitrazepam therapy. At age 3-years, the child is seizure-free and shows normal neurologic development.