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This study describes complex partial seizures in infants, noting unique behavioral and EEG patterns. These infantile seizures are often misdiagnosed despite distinct clinical and electrophysiological findings.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Neurophysiology
Background:
- Complex partial seizures in infants are poorly understood.
- Previous descriptions of infantile seizures lack detailed ictal manifestations.
Purpose of the Study:
- To describe the ictal manifestations of complex partial seizures in infants.
- To characterize the electroencephalographic (EEG) and behavioral patterns of these seizures.
Main Methods:
- Long-term video-electroencephalographic (EEG) and telemetric monitoring.
- Recording of 187 seizures in 14 infants under 2 years of age.
- Analysis of behavioral seizure patterns and EEG findings.
Main Results:
- Common manifestations included behavioral arrest, forced lateralized head/eye deviation, and tonic upper-extremity stiffening.
- Facial automatisms like chewing and blinking were frequent.
- EEG showed lateralized ictal onset with multifocal interictal discharges.
Conclusions:
- Infantile complex partial seizures present distinct ictal behaviors and EEG patterns.
- These seizures are often associated with profound developmental delay and intractable epilepsy.
- Current routine evaluations may miss these distinctive seizure patterns.
Abstract:
Ictal manifestations of complex partial seizures in infancy have not been described previously. Using long-term video/electroencephalographic and telemetric monitoring techniques, 187 seizures were recorded in 14 infants under 2 years of age. With one exception, the infants were profoundly delayed with intractable seizures. Nine had marked bilateral abnormalities on computed tomographic scan. The seizure manifestations noted most frequently consisted of behavioral arrest with forced lateralized deviation of the head and eyes and tonic upper-extremity extensor stiffening. Complex facial automatisms such as chewing, sucking, mouthing, and blinking were relatively common. Ictal paroxysmal onset was always lateralized on electroencephalograms, whereas the interictal recordings revealed multifocal epileptic discharges, generalized slowing, and voltage attenuation. The ictal behavioral manifestations and electric seizure patterns were quite distinctive yet were often undiagnosed on routine evaluations.