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Summary
Apneic attacks in children can be a sole or accompanying symptom of epileptic seizures. These seizures, often linked to the limbic system, manifest as respiratory issues and cyanosis, confirmed by EEG.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Neuroscience
Background:
- Epileptic seizures can present with diverse and sometimes atypical symptoms.
- Apneic attacks, characterized by respiratory compromise, are rarely recognized as a primary manifestation of epilepsy in children.
Observation:
- Five pediatric cases of apneic attacks as a manifestation of epileptic seizures were reported.
- Apneic seizures, lasting 1-2 minutes, involved respiratory embarrassment and early cyanosis, with impaired consciousness difficult to assess in infants.
- Ictal electroencephalograms (EEGs) consistently showed focal onset paroxysmal discharges, predominantly in temporal, frontal, or central areas.
Findings:
- In three children, apneic attacks were the exclusive seizure symptom; the other two experienced additional seizure types.
- EEG findings included high-amplitude theta-waves, sharp waves, spikes, or fast/slow wave complexes.
- Interictal EEGs were largely unremarkable, highlighting the diagnostic importance of ictal recordings.
Implications:
- Apneic attacks in infants are considered an integral component of complex partial seizures, often originating in the limbic system.
- Recognition of these seizures is crucial for accurate diagnosis and appropriate management of pediatric epilepsy.
- This highlights the need for thorough neurological evaluation, including EEG, in infants presenting with unexplained apneic episodes.