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Prolonged nonepileptic twilight state with convulsive manifestations after febrile convulsions: a clinical and

N Yamamoto1

  • 1Division of Pediatrics, Aihoku Hospital, Aichi, Japan.

Epilepsia
|January 1, 1996
PubMed

Insights

Prolonged febrile seizures in infants may present as nonepileptic twilight states with convulsive manifestations (NETC), not epilepsy. EEG shows slow wave activity, suggesting a prolonged arousal state rather than seizures.

Area of Science:

  • Neuroscience
  • Pediatric Neurology
  • Clinical Electrophysiology

Background:

  • Prolonged febrile seizures are a common concern in pediatric neurology.
  • Distinguishing between epileptic and nonepileptic events is crucial for accurate diagnosis and treatment.

Purpose of the Study:

  • To investigate the electroencephalogram (EEG) characteristics of infants experiencing prolonged febrile seizures.
  • To differentiate these events from epileptic seizures based on EEG patterns.

Main Methods:

  • Obtained EEGs from 14 infants during clinically diagnosed prolonged febrile seizures.
  • Analyzed EEG waveforms for epileptiform activity and characterized slow wave patterns.

Main Results:

  • Clinical manifestations mimicked complex partial seizures (CPS) but EEG showed no epileptiform activity.
  • Two distinct slow wave patterns were observed: continuous diffuse delta (CDD) and diffuse rhythmic theta (DRT) waves.
  • These EEG patterns were termed "nonepileptic twilight states with convulsive manifestations" (NETC).

Conclusions:

  • NETC states, characterized by CDD and DRT waves, are likely prolonged arousal states, not epileptic seizures.
  • The findings suggest a link between febrile convulsions and prolonged arousal with increased muscle tone.

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