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Clinical profile of partial seizures beginning at less than four years of age

W T Blume1

  • 1Epilepsy Unit, University Hospital, London, Ontario, Canada.

Epilepsia
|November 1, 1989
PubMed

Insights

Early-onset partial seizures in children often present with motor symptoms. Electroencephalography (EEG) and neuroimaging reliably localize seizure origins, aiding diagnosis.

Area of Science:

  • Pediatric Neurology
  • Epilepsy Research
  • Clinical Neurophysiology

Background:

  • Recurrent partial seizures beginning in early childhood (<= 47 months) present unique clinical challenges.
  • Understanding the diverse seizure manifestations and origins is crucial for effective management.

Purpose of the Study:

  • To analyze the clinical features, electroencephalographic (EEG) findings, and neuroimaging results in a cohort of pediatric patients with early-onset partial seizures.
  • To determine the reliability of interictal EEG and computed tomography (CT) scans in localizing seizure onset.

Main Methods:

  • Retrospective review of clinical data, EEG recordings, and CT scans from 46 patients with early-onset partial seizures.
  • Correlation of seizure semiology, EEG abnormalities (spikes, delta activity), neurological signs, and CT findings with the lobe/hemisphere of seizure origin.

Main Results:

  • Motor seizures were prevalent (80%), occurring unilaterally, bilaterally, or both. Complex partial seizures (CPS) were common (72%).
  • EEG accurately localized seizure origin in most cases (spikes 97%, delta activity 92%). Neurological signs and CT findings also correlated well with seizure origin (90% for CT).
  • Frontal lobe seizures were most frequent (48%), followed by temporal lobe (30%). Cortical developmental abnormalities were the leading cause (26%).

Conclusions:

  • Early-onset partial seizures exhibit varied clinical presentations.
  • Interictal EEG and neuroimaging are highly effective tools for lateralizing and localizing the seizure onset zone in pediatric epilepsy.
  • Cortical developmental abnormalities are a significant etiology in this patient group.

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