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Benign partial epilepsy with secondarily generalized seizures in infancy
1Department of Pediatrics, Nagoya University School of Medicine, Japan.
Insights
This study identifies a benign form of infantile epilepsy where partial seizures secondarily generalize. These seizures are effectively managed with phenobarbital or carbamazepine, leading to positive developmental outcomes.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Neuroscience
Background:
- Benign idiopathic partial epilepsy in infancy can present with seizures that appear generalized.
- These seizures often evolve from focal onset to secondarily generalized tonic-clonic seizures (GTCs).
Purpose of the Study:
- To characterize a specific syndrome of benign partial epilepsy in infants.
- To evaluate the efficacy of common antiepileptic drugs and long-term outcomes.
Main Methods:
- Case series analysis of seven infants with epilepsy.
- Clinical observation of seizure manifestations and EEG findings.
- Assessment of treatment response and developmental outcomes.
Main Results:
- All seven infants experienced partial seizures that evolved into GTCs.
- Phenobarbital or carbamazepine provided effective seizure control.
- Seizure freedom was maintained for over 3 years post-medication, with normal development.
Conclusions:
- A distinct syndrome of benign partial epilepsy in infancy is proposed.
- This epilepsy type is characterized by focal seizures that generalize.
- Early treatment with phenobarbital or carbamazepine leads to favorable long-term prognosis.
Abstract:
Seven infants with benign idiopathic partial epilepsy presented with apparently generalized tonic-clonic seizures (GTCs) which proved to be partial seizures evolving to secondarily generalized seizures. All were easily controlled with phenobarbital (PB) or carbamazepine (CBZ), and remained seizure-free > 3 years even after discontinuation of medication, and had a normal developmental outcome. The initial seizure manifestation consisting of motion arrest, staring or blank eyes, or crying associated with focal paroxysmal discharges was followed by GTCs in accordance with generalization of paroxysmal discharges. Four infants had a family history of benign type of childhood convulsions. The term "benign partial epilepsy in infancy" is proposed to combine this syndrome with the previously described benign infantile epilepsy with complex partial seizures.