A multi-institutional collaborative study was conducted concerning the course of pregnancy and delivery and the incidence of abnormal infants delivered of epileptic women. Of 657 women receiving antiepileptic drugs, 73% delivered live infants, 14% had miscarriage or stillbirth, and 13% underwent induced abortion. In contrast to the above findings, 80% of 162 patients not receiving antiepileptic drugs delivered live infants and 4% had miscarriage or stillbirth. The latter outcome was significantly increased in the medicated patients. In this series, 63 (9.9%) of 638 live births were malformed, 55 (11.5%) being from medicated mothers and 3 (2.3%) from nonmedicated mothers. The incidence of fetal malformation in medicated mothers was thus five times as high as that in nonmedicated mothers. Cleft lip and/or palate and malformations involving the cardiovascular system were found frequently in the infants from medicated mothers. General background factors that might exert teratogenic effects on pregnant patients with epilepsy were studied, and the potential toxicity of antiepileptic drugs to the fetus was also analyzed. In this regard, consideration should be given to whether the patient has partial epileptic seizures, whether the patient herself exhibits any malformation, or whether her previous pregnancy resulted in an abnormal outcome. The incidence of fetal malformation was the highest (12.7%) in the medicated patients who had epileptic seizures during the pregnancy. It is presumed on the basis of the results of analysis of the data that a combination of more than three drugs and a daily dose greater than a certain minimal level is likely to produce malformed infants.

Despite ready bilateralization of ictal and interictal EEG discharge throughout cortical kindling, the rate of convulsive seizure development was slow at both orbital and mesial frontal sites, even in the epileptic baboon. However, convulsive generalization occurred swiftly from the mesial frontal cortical (MF) sites once conjugate head, eye, and body adversion developed in the three primate species examined. Only epileptic baboons developed Stage 5 bisymmetrical and bisynchronous convulsion. Stimulation of the contralateral homotopic mesial cortical site readily produced afterdischarge that remained localized and convulsive seizure development did not occur. The findings suggest that (a) the frontal lobe plays an important role in the generation of nonconvulsive seizures, (b) the frontorolandic cortex plays a unique role in convulsive seizure generalization, (c) the role of the intrinsic (genetic) factor is significant in determining the quality of the kindled seizure, and (d) the development of focal epileptogenesis at one MF site interferes with clinical seizure development at the "mirror focus." Our findings underscore (a) the necessity of the conceptual differentiation between the EEG mirror focus and the epileptogenic focus capable of generating clinical seizures and (b) the importance of dissecting interictal behavior reflecting a "continuous disorder of neuronal function," which may cause symptoms other than seizures.

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SUMMARY On 62 cases with Lennox‐Gastaut's syndrome aged four to 31, the clinical‐electro‐encephalographic findings were summarized as follows; (1) Age of onset was over 10 years in 10 cases (16.1%). Mental deficiencies were more severe in those with onset earlier than age three. Behavioral problems were observed in 34 cases (54.8%); 21 with hyperactive and 13 with hypoactive ones ‐ 18 hyperactive cases (85.7%) with the onset taking place before age six, and 12 hypoactive cases (92.3%), all whose age is now over 10. The number of clinical seizures showed a tendency in which monoictal manifestation decreased from 25 to three whereas polyictal one increased from 13 to 59 cases during the course of a decade. Interictal EEG findings were pseudo‐rhythm of slow spike‐wave with or without focal spikes, and so‐called runs of rapid spikes during sleep recording. Focal spikes were observed in 25 cases (40.3%); mainly in the frontal area among those under 10 years old, and in the anterior temporal area among those over 20. The rapid spikes were demonstrated in 19 cases (30.6%) in the over‐15 age group and appeared to be correlated with epileptic drop seizures and atypical complex absences.