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Partial epilepsy in neurologically normal children: clinical syndromes and prognosis
Insights
Benign partial epilepsy of childhood with rolandic spikes (BPEC) was confirmed in children with partial seizures. Other idiopathic partial epilepsy syndromes appear rare and difficult to predict, requiring further study.
Area of Science:
- Neurology
- Pediatrics
- Epileptology
Background:
- Partial seizures in children are diverse, with some syndromes well-defined and others less understood.
- Identifying specific epileptic syndromes is crucial for accurate diagnosis and prognosis in pediatric epilepsy.
Purpose of the Study:
- To verify the existence and frequency of reported epileptic syndromes in neurologically normal children with partial seizures.
- To investigate the clinical and electroencephalographic characteristics of different partial epilepsy syndromes in childhood.
Main Methods:
- A clinical and electroencephalographic study was conducted on 107 neurologically normal children diagnosed with partial seizures.
- Children were classified based on seizure type: simple partial seizures, complex partial seizures, or unclassifiable.
Main Results:
- The syndrome of benign partial epilepsy of children with rolandic spikes (BPEC) was identified in 38 cases, confirming its benign prognosis.
- No homogeneous subgroups were found among children with simple partial seizures outside BPEC (25 cases) or complex partial seizures (39 cases).
- Two cases of "atypical benign partial epilepsy of childhood" and one of "benign epilepsy with occipital spike-waves" were identified.
Conclusions:
- Benign partial epilepsy of childhood with rolandic spikes (BPEC) is a clearly identifiable syndrome with a uniformly benign prognosis.
- While a benign course is not exclusive to BPEC, predicting it is challenging for other idiopathic partial epilepsies in childhood.
- Further prospective studies are needed to confirm well-defined benign syndromes within idiopathic partial epilepsies outside of BPEC.
Abstract:
A clinical and electroencephalographic study of 107 neurologically normal children with partial seizures was undertaken to verify the existence and determine the frequency of epileptic syndromes reported in selected populations. Sixty-three children had simple partial seizures, 39 had complex partial seizures, and 5 children were unclassifiable. The syndrome of benign partial epilepsy of children with rolandic spikes (BPEC, 38 cases) was clearly identified and its uniformly benign final prognosis was confirmed even if some of these children had at times severe or poorly controlled seizures. Among the children with simple partial seizures outside the BPEC (25 cases) and complex partial seizures (39 cases), no homogeneous clinical or electroclinical subgroup could be found. Two children with benign partial epilepsy and myoclonic-astatic seizures ("atypical benign partial epilepsy of childhood") and one child with "benign epilepsy with occipital spike-waves" were identified. 74% of children with epilepsy with complex partial seizures (ECP) had a 1-year seizure-free interval, and many children with epilepsy with simple partial seizures outside the BPEC group (ESP) had no more than two seizures. A benign course is thus not limited to the BPEC but is difficult to predict. Prospective studies are necessary to confirm the existence of well-defined benign syndromes among the idiopathic partial epilepsies of childhood, which appear quite rare outside the BPEC.