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Partial epilepsy in childhood: clinical and EEG study of 261 cases
Insights
This study on pediatric epilepsy found that perinatal issues are a key cause of partial seizures. While many cases have a favorable outcome with treatment, EEG abnormalities often change over time.
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
- Epilepsy Research
Background:
- Partial seizures in children, with or without focal electroencephalogram (EEG) abnormalities, and generalized seizures with focal EEG disturbances, are common neurological conditions.
- Understanding the etiology, clinical presentation, and EEG characteristics is crucial for effective management of pediatric epilepsy.
Purpose of the Study:
- To prospectively investigate the clinical and EEG features of partial and generalized seizures in a cohort of 261 children.
- To identify etiological factors, clinical outcomes, and EEG evolution in pediatric epilepsy.
Main Methods:
- A prospective clinical and EEG study involving 261 children with epilepsy.
- Detailed clinical assessment of seizure types, onset, frequency, and associated neurological syndromes.
- Serial EEG recordings to evaluate abnormalities, localization, and changes over time.
Main Results:
- Elementary and motor partial seizures were most frequent, often associated with generalized seizures (64.36%) and typically beginning in the first year of life.
- Perinatal disturbances were identified as the most significant etiological factor, with secondary epilepsy being common.
- A favorable clinical outcome (71.72%) was observed with treatment, particularly in primary epilepsy cases with infrequent seizures starting after the first year.
- Monofocal EEG abnormalities (72.79%), predominantly temporal and rolandic, were noted; EEG abnormalities modified in 58.89% of cases during follow-up, with 22.98% normalizing.
Conclusions:
- Perinatal factors play a critical role in the etiology of pediatric partial epilepsy.
- Therapeutic intervention leads to favorable outcomes in a majority of children, especially in primary epilepsy.
- EEG findings in pediatric epilepsy are dynamic, with significant modifications and occasional normalization observed during follow-up.
Abstract:
A prospective clinical and EEG study is presented based on 261 children affected by partial seizures with or without focal EEG abnormalities, or by generalized seizures with focal EEG disturbances. From the clinical point of view, the partial seizures were most frequently elementary and motor, quite often associated with generalized seizures (64.36%), appearing in the majority of the cases during the first year of life, with rare frequency (less than 1 seizure/6 months). Perinatal disturbances appear to be the most important etiological factor. Partial epilepsy is often included within a previous neurological syndrome (secondary epilepsy). The clinical outcome is most frequently favorable (71.72%) with therapeutic treatment, especially with respect to the cases of primary epilepsy, characterized by rare seizures, which appear after the first year of life. From the EEG point of view, we noted specific monofocal abnormalities (72.79%), most frequently with temporal and rolandic localisation; during the follow-up the EEG abnormalities presented modifications in 58.89% of the cases, with normalisation in 22.98%.