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Epileptic syndromes in children with somatosensory evoked spikes
1Department of Neuropsychiatry, Pontificia Universidade Católica de Campinas, Brazil.
Insights
This study found that evoked seizures (ES) in children are often linked to epilepsy. While some cases may represent a benign, age-dependent functional condition, many show clear epileptic activity on EEG.
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
- Epileptology
Background:
- Evoked seizures (ES) are paroxysmal events triggered by specific stimuli like tapping.
- Understanding the underlying mechanisms and clinical significance of ES in children is crucial.
Purpose of the Study:
- To investigate the prevalence and characteristics of evoked seizures in children.
- To differentiate between epileptic and potentially benign functional causes of ES.
Main Methods:
- Electroencephalography (EEG) was used to record brain activity in 186 children with frequent ES.
- Patient history regarding epileptic seizures and seizure types (febrile/non-febrile, partial/generalized) was collected.
- Comparison with a control group with normal EEG was performed.
Main Results:
- 40.3% of children with ES had a history of epileptic seizures.
- Non-febrile seizures were more common in the ES group than controls.
- Spontaneous epileptiform activity was observed in 85.3% of children with seizures, and 39.6% without seizures.
- Parietal lobe involvement was noted in a significant proportion of cases with spontaneous focal spikes.
Conclusions:
- Evoked seizures in children are frequently associated with underlying epilepsy.
- A subset of ES may represent a benign, age-dependent functional neurological disorder, primarily affecting the parietal lobe.
- Further research is needed to clearly characterize these entities and differentiate them from established epileptic syndromes.
Abstract:
We studied 186 children with frequent EEG paroxysms evoked by tapping of the feet or hands (ES). Seventy-five (40.3%) patients had a history of epileptic seizures. Febrile convulsions alone occurred in 31 (16.7%) of the children and nonfebrile in 44 cases (23.7%). Non-febrile seizures occurred in a greater proportion among patients with ES than in a control group with normal EEG. Spontaneous epileptiform activity was recorded in 39.6% of the patients without epileptic seizures but in a great percentage of the children with seizures (85.3%). The non-febrile seizures were partial in 26 cases and generalized in 18. In 39 of these cases the EEG also showed spontaneous focal spikes, which occurred predominantly in the parietal regions in 24 cases. ES were observed in different types of partial and generalized epilepsies of childhood. Our findings also suggest that in an important proportion of cases there is a benign condition of a functional nature that is age-dependent, involving mainly the parietal lobe but in which seizure type does not so easily permit definition as a clearly characterized epileptic entity compared to other recognized idiopathic partial childhood epilepsies.