Benign Idiopathic Partial Epilepsy and Brain Lesion

Stephani, Ulrich; Doose, H

doi:10.1111/j.1528-1157.1999.tb00721.x

Cited by 18 publications

(15 citation statements)

References 16 publications

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“…The EEG findings of many children reinforced this impression, with an abundance of stereotyped epileptiform discharges recorded over the centrotemporal and occipital regions bilaterally or with a multifocal distribution. Idiopathic partial epilepsy in children with brain damage is reported, often manifesting atypically with frequent seizures or interictal disturbances 27,28 . Our data support the suggestion that, despite an abnormal neurological examination and known brain injury, children with CP may have seizure characteristics similar to children with idiopathic epilepsy.…”

Section: Discussionsupporting

confidence: 81%

“…Idiopathic partial epilepsy in children with brain damage is reported, often manifesting atypically with frequent seizures or interictal disturbances. 27,28 Our data support the suggestion that, despite an abnormal neurological examination and known brain injury, children with CP may have seizure characteristics similar to children with idiopathic epilepsy. Implications for management may include avoidance of certain antiepileptic medications with potential to exacerbate idiopathic epilepsies, such as carbamazepine, 29 avoidance of prolonged antiepileptic drug therapy in seizurefree children, and avoidance of repeated EEGs.…”

Section: Discussionsupporting

confidence: 81%

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Epilepsy in hemiplegic cerebral palsy due to perinatal arterial ischaemic stroke

Wanigasinghe

Reid

Mackay

et al. 2010

Develop Med Child Neuro

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AIM The aim of this study was to describe the frequency, risk factors, manifestations, and outcome of epilepsy in children with hemiplegic cerebral palsy (CP) due to perinatal arterial ischaemic stroke (AIS). METHODThe study group comprised 63 participants (41 males, 22 females) from a populationbased CP register whose brain imaging showed perinatal AIS. Information collected included occurrence of neonatal seizures, family history of epilepsy, motor function and epilepsy onset, treatment, and outcome. Electroclinical findings were classified according to seizure semiology, seizure type, and epilepsy syndrome.RESULTS Mean age of participants at the time of study was 10 years 6 months (SD 4y 7mo, range 4-20y). Gross Motor Function Classification System levels I and II were reported in 96% of participants, and Manual Ability Classification System levels I and II were reported in 79% of children. Thirty-four children (54%) developed epilepsy. Term delivery and more severe motor impairment were associated with epilepsy, but neonatal seizures and family history of epilepsy were not. Initial seizures were epileptic spasms, focal seizures, or myoclonic seizures. Focal seizure semiology suggested Rolandic or occipital seizure origin in the majority of children. Focal epileptic discharges in children with focal seizures had features of idiopathic partial epilepsy. Only 15% of children had active epilepsy 10 years after onset.INTERPRETATION Despite a high incidence of epilepsy in children with hemiplegic CP due to AIS, the prognosis for seizure remission is good. Many children have clinical features, electroencephalography findings, and remission typical of idiopathic partial epilepsy.Epilepsy is a significant comorbidity in children with cerebral palsy (CP), potentially affecting cognitive development, mobility, and the ability to live independently. Estimates of the frequency depend on the pathology, the type of motor impairment, or both.1,2 Most studies have included multiple CP subtypes with diverse or uncertain aetiologies, and none has included detailed epilepsy evaluations with epilepsy syndrome classification. Little is known about risk factors and long-term outcome for specific epilepsy syndromes in a particular CP subtype.This study aimed to describe the epileptology in a group of young people with a common pathology and aetiology, namely children with hemiplegic CP resulting from perinatal arterial ischaemic stroke (AIS). We looked at risk factors, frequency and types of seizures, epilepsy syndromes, evolution of the epilepsy, and quality of life.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 81%

Epilepsy in hemiplegic cerebral palsy due to perinatal arterial ischaemic stroke

Wanigasinghe

Reid

Mackay

et al. 2010

Develop Med Child Neuro

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“…30 The normal EEG in one patient does not exclude benign occipital epilepsy, as normal interictal EEGs are reported in up to 10% of children. 31 Idiopathic or benign focal epilepsies, both occipital and Rolandic varieties, as well as centrotemporal and occipital spikes, are not uncommon in children with a variety of static brain lesions [32][33][34][35][36] and developmental disabilities. [36][37][38] These focal epilepsies and IEDs are conceptualized as maturational phenomena rather than genetically determined, ion-channel mediated disorders, [39][40][41] and the relationship to the underlying neurodevelopmental disorder or lesion is thought to be indirect or coincidental.…”

Section: Discussionmentioning

confidence: 99%

Variable outcome for epilepsy after neonatal hypoglycaemia

Fong

Harvey

2014

Develop Med Child Neuro

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ABBREVIATION IEDsInterictal epileptiform discharges AIM To evaluate the electroclinical features of epilepsy secondary to neonatal hypoglycaemia.METHOD This was a retrospective study of children who had seizures beyond infancy after neonatal hypoglycaemia treated at The Royal Children's Hospital, Melbourne between 1996 and 2012. Patients with perinatal asphyxia were excluded. Clinical details were obtained from medical records. Digital electroencephalography (EEG) and brain magnetic resonance imaging (MRI) were reviewed. Eleven patients met the inclusion criteria (six males, five females; mean age 10y 5mo, range 4-18y at the time of review).RESULTS Age at seizure onset ranged from 4 months to 5 years. Seizures were focal occipital in nine and generalized tonic in two patients. MRI showed gliosis with or without cortical atrophy in the occipital lobe with or without parietal lobe in all. Predominant EEG findings were stereotyped occipital sharp-slow discharges in five, polymorphic occipital spike-wave or paroxysmal fast activity in three, and generalized slow spike-wave and fast activity in two. Seizures were infrequent or remitted in six of the nine children with focal occipital seizures, and frequent and refractory in both children with generalized seizures.INTERPRETATION Despite the common antecedent and bilateral occipital lobe injury, the seizure manifestations and course of epilepsy after neonatal hypoglycaemia were variable, with mild occipital, refractory occipital, and symptomatic generalized epilepsy recognized.

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“…This also is true for other brain MRI abnormalities that may suggest symptomatic epilepsy in a patient whose EEG and clinical course is consistent with BFEDCs. A report (16) described a 14‐year‐old girl with clinical and EEG features of BFEDCs after a severe head trauma. The course of the epilepsy in the patient was like that in BFEDCs, and her normal sister also had BFEDCs on a routine EEG.…”

Section: Discussionmentioning

confidence: 99%

Benign Focal Epileptiform Discharges of Childhood and Hippocampal Sclerosis

et al. 2004

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Summary:Purpose: Benign focal epileptiform discharges of childhood (BFEDCs) are common EEG findings between ages 4 and 14 years. This epoch of maturational development overlaps with the age at presentation of temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS) in children.Methods: From our series of 17 preadolescent children who eventually underwent anteromesial temporal resection for medically refractory TLE due to HS, we identified two children, plus one thereafter, who were initially dismissed as candidates for epilepsy surgery because of abundant extratemporal sharp waves, which were bilateral in two cases. The sharp waves had the distinctive morphology, distribution, and sleep activation suggestive of BFEDCs, but the medical intractability and seizure symptoms were unusual for benign focal epilepsy of childhood.Results: In each case, surgical candidacy was clarified when magnetic resonance imaging (MRI) showed unilateral HS and video-EEG demonstrated seizure onset in the ipsilateral anteromesial temporal region. The postoperative freedom from seizures in each case (follow-up, 2 to 4 years) confirmed that HS was the primary epileptogenic process, and that the BFEDCs were incidental or an atypical secondary manifestation.Conclusions: These cases illustrate the need for more extensive study of children with BFEDCs when medical intractability and seizure symptoms speak against a simple diagnosis of benign focal epilepsy of childhood. In addition, we observed that the BFEDCs in two of our children had an unusual bilateral occipitofrontal distribution, and we speculate that the coexistence of the BFEDCs in children with HS may not be an incidental finding.

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Benign Idiopathic Partial Epilepsy and Brain Lesion

Cited by 18 publications

References 16 publications

Epilepsy in hemiplegic cerebral palsy due to perinatal arterial ischaemic stroke

Epilepsy in hemiplegic cerebral palsy due to perinatal arterial ischaemic stroke

Variable outcome for epilepsy after neonatal hypoglycaemia

Benign Focal Epileptiform Discharges of Childhood and Hippocampal Sclerosis

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