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Functional partial epilepsies in childhood.

T Morikawa, N Terauchi, H Shigematsu

    The Japanese Journal of Psychiatry and Neurology
    |September 1, 1986
    PubMed
    Summary
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    Functional partial epilepsies (FPE) in children are not always benign, even with EEG findings similar to Rolandic spikes. Differentiating FPE from typical benign epilepsy of children with centro-temporal EEG foci (BECCT) is crucial for accurate seizure prognosis.

    Area of Science:

    • Pediatric Neurology
    • Clinical Electrophysiology
    • Epileptology

    Background:

    • Partial epilepsies in children present diagnostic challenges.
    • Distinguishing functional partial epilepsies (FPE) from organic forms is critical for management.
    • Rolandic spikes on EEG are often associated with benign epilepsy syndromes.

    Purpose of the Study:

    • To compare interictal EEG findings in functional and organic partial epilepsies.
    • To evaluate the prognostic significance of EEG findings, particularly those resembling Rolandic spikes, in pediatric partial epilepsies.
    • To stress the importance of differentiating typical benign epilepsy of children with centro-temporal EEG foci (BECCT) from FPE.

    Main Methods:

    • Retrospective analysis of 314 children with partial epilepsies followed for over 5 years.

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  • Identification and classification of 122 children with functional partial epilepsies (FPE).
  • Comparison of interictal EEG findings, focusing on centro-temporal and other focal patterns, between FPE and organic epilepsies.

    • Main Results:

    • Functional partial epilepsies (FPE) constituted 39% of the studied cohort.
    • Only 45% of FPE cases met the criteria for typical benign epilepsy of children with centro-temporal EEG foci (BECCT).
    • Unfavorable seizure control was more frequent in FPE with frontal or multiple EEG foci compared to centro-temporal or occipital foci.
    • EEG spikes resembling Rolandic spikes were observed in over 50% of both functional and organic partial epilepsies, challenging their benign implication.

    Conclusions:

    • Recurrent interictal spikes, even those similar to Rolandic spikes, do not guarantee a benign seizure prognosis.
    • Functional partial epilepsies (FPE) can present with diverse EEG focal patterns beyond the typical centro-temporal.
    • Accurate differential diagnosis between BECCT and FPE is essential for appropriate patient management and prognostic assessment.