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Long-Term Clinical and Electroencephalography (EEG) Consequences of Idiopathic Partial Epilepsies
Nimet Dörtcan1, Betul Tekin Guveli2, Aysin Dervent3
1Department of Neurology and Neurophysiology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey.
Insights
Idiopathic partial epilepsies of childhood (IPE) show age-related seizure and EEG patterns. Understanding these patterns aids in managing IPE and predicting outcomes for conditions like Benign Childhood Epilepsy with Centro-temporal Spikes.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Neurophysiology
Background:
- Idiopathic partial epilepsies of childhood (IPE) encompass significant childhood neurological disorders.
- Key IPE syndromes include Benign Childhood Epilepsy with Centro-temporal Spikes (BECTS), Panayiotopoulos Syndrome (PS), and Childhood Epilepsy with Occipital Paroxysms (CEOP).
- Long-term prognosis and syndromic characteristics require further investigation.
Purpose of the Study:
- To investigate the long-term prognosis of patients diagnosed with IPE.
- To analyze semiological and electroencephalography (EEG) data in relation to IPE syndromic characteristics.
- To correlate seizure types and EEG findings with age-specific patterns.
Main Methods:
- Inclusion of consecutive IPE patients followed since 1990.
- Categorization into three groups: single IPE syndromes, intermediate IPE characteristics, and combined IPE/IGE characteristics.
- Re-evaluation of long-term seizure types and EEG findings.
Main Results:
- Autonomic seizures are prevalent in 2-5 year olds; oromotor seizures peak at 9-11 years.
- Electroencephalography (EEG) abnormalities are most frequent between 6-8 years.
- Parietooccipital epileptic activity (EA) is prominent at 2-5 years, shifting to fronto-temporal or multiple sites by 6-11 years.
Conclusions:
- IPE syndromes exhibit distinct age-related seizure and EEG characteristics.
- Recognition of these age-specific phenomena can enhance IPE management.
- Improved understanding facilitates better prediction of long-term consequences for childhood epilepsy.
Abstract:
BACKGROUND Idiopathic partial epilepsies of childhood (IPE) affect a considerable proportion of children. Three main electroclinical syndromes of IPE are the Benign Childhood Epilepsy with Centro-temporal Spikes (BECTS), Panayiotopoulos Syndrome (PS), and Childhood Epilepsy with Occipital Paroxysms (CEOP). In this study we investigated the long-term prognosis of patients with IPE and discussed the semiological and electroencephalography (EEG) data in terms of syndromic characteristics. MATERIAL AND METHODS This study included a group of consecutive patients with IPE who had been followed since 1990. Demographic and clinical variables were investigated. Patients were divided into 3 groups - A: Cases suitable for a single IPE (BECTS, PS and CEOP); B: cases with intermediate characteristics within IPEs; and C: cases with both IPE and IGE characteristics. Long-term data regarding the individual seizure types and EEG findings were re-evaluated. RESULTS A total of 61 patients were included in the study. Mean follow-up duration was 7.8 ± 4.50 years. The mean age at onset of seizures was 7.7 years. There were 40 patients in group A 40, 14 in group B, and 7 in group C. Seizure and EEG characteristics were also explored independently from the syndromic approach. Incidence of autonomic seizures is considerably high at 2-5 years and incidence of oromotor seizures is high at age 9-11 years. The EEG is most abnormal at 6-8 years. The vast majority (86%) of epileptic activity (EA) with parietooccipital is present at 2-5 years, whereas EA with fronto-temporal or multiple sites become more abundant between ages 6 and 11. CONCLUSIONS Results of the present study provide support for the age-related characteristics of the seizures and EEGs in IPE syndromes. Acknowledgement of those phenomena may improve the management of IPEs and give a better estimate of the future consequences.
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