Clinical Study on Localization-Related Epilepsy in Infancy Without Underlying Disorders

Takeuchi, Yoshihiro; Matsushita, Hiroko; Yamazoe, Ichiro; Nagai, Hideyuki; Takaya, Kazushi; Fujiwara, F; Sawada, Tadashi

doi:10.1016/s0887-8994(98)00007-1

Cited by 9 publications

(11 citation statements)

References 19 publications

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“…This has been discussed and refuted by Watanabe et al (6). Takeuchi et al (11) evaluated 15 patients with partial epilepsy younger than 1 year and concluded that, even in the group of patients with normal MRIs, 40% had poor outcome, challenging the entity of BPEI. One possible explanation is that the quality of MRIs in young children at the time of the study in 1998 may not have been sufficient to allow the discovery of subtle dysplastic lesions in the 10 patients who had an abnormal EEG and psychomotor retardation.…”

Section: Discussionsupporting

confidence: 91%

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Benign Partial Epilepsy in Infancy: Myth or Reality?

Kaleyias¹,

Khurana²,

Valencia³

et al. 2006

Epilepsia

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Summary:Purpose: Benign partial epilepsy in infancy (BPEI) was first described by Watanabe in 1987. The aim of this study is to describe a series of infants from the United States to characterize this entity further.Methods: Among patients with the diagnosis of epilepsy followed up at our institution between 2002 and 2004, those satisfying the criteria for BPEI were included in a retrospective study.Results: Sixteen (10.2%) of 150 patients with new onset of epilepsy younger than 2 years were identified. The mean age at seizure onset was 8 months. Four (25%) infants had a family history of benign seizures. All infants were neurologically and developmentally normal at the onset of seizures. The seizures occurred in clusters in 75% of patients, predominantly in wakefulness. The initial manifestation was behavioral arrest with staring (69%) and apnea with cyanosis or pallor (37.5%). These symptoms were followed by deviation of eyes or head or both (56%), mild clonic movements (31%), or increased limb tone (35%). Secondary generalization was noticed in 37.5% of patients. All infants had normal interictal EEGs and brain MRIs. Ictal EEGs disclosed electrographic seizures in 50% of patients (temporal origin in 62% and central in 38%). Fifteen (94%) patients were treated with AEDs with good response. The mean duration of treatment was 12.4 months. The final developmental assessment of all patients was normal.Conclusions: We believe that BPEI exists as a unique entity and should be included in the differential diagnosis of epilepsies in infancy with partial origin.

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Section: Discussionsupporting

confidence: 91%

“…Dulac et al (3) stressed the absence of benign partial epilepsy between the ages of 3 and 15 months. Takeuchi et al (11) reported a series of 15 infants with localization‐related epilepsy without underlying disorders, 10 of whom fit the description of BPEI. However, 40% of them had a poor outcome with associated developmental retardation.…”

mentioning

confidence: 99%

Benign Partial Epilepsy in Infancy: Myth or Reality?

Kaleyias¹,

Khurana²,

Valencia³

et al. 2006

Epilepsia

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“…Arrest of the activity is a prominent feature of hypomotor seizures in infants and toddlers. Hypomotor symptoms occur in 30–40% of infants and toddlers with epilepsy . One characteristic of hypomotor seizures in this age group is the evolution into other focal motor features, generalized seizures, or infantile spasms …”

Section: Discussionmentioning

confidence: 99%

“…The absence of these features could clinically differentiate behavioral PNEE from seizure in infants and toddlers. Automatism, in particular oral automatisms, have been described in 22–40% of seizures in young children, but do not usually occur at seizure onset and occur more frequently with evolution of the seizure …”

Section: Discussionmentioning

confidence: 99%

Paroxysmal non‐epileptic events in infants and toddlers: A phenomenologic analysis

Chen

Pestana-Knight

Tuxhorn

et al. 2014

Psychiatry Clin Neurosci

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Aim:The aim of this study was to analyze in detail the clinical phenomenology of paroxysmal nonepileptic events (PNEE) in infants and toddlers. Methods:We studied all children aged ≤2 years who were diagnosed with PNEE based on videoelectroencephalographic (VEEG) recordings. We analyzed the following four clinical domains of each clinical event: (i) motor manifestations (body/limb jerking, complex motor, and asymmetric limb posturing); (ii) oral/vocal (crying, vocalization, sighing); (iii) behavioral change (arrest of activity, staring); (iv) and autonomic (facial flushing, breath holding).Results: Thirty-one of 81 (38.3%) infants and toddlers had 38 PNEE recorded during the study period (12 girls and 19 boys, mean age 10.5 months). The predominant clinical features were as follows: motor in 26/38 events, oral/verbal in 14/38 events, behavioral in 11/38 events, and autonomic in 8/38 events. Epileptic seizures and PNEE coexisted in four children (12.9%). Seventeen children (54.8%) had one or more risk factors suggestive of epilepsy. Twelve children (38.7%) had a normal neurologic examination, 10 (32.3%) had developmental delay, and eight (25.8%) had a family history of epilepsy or seizures.Conclusion: VEEG recorded PNEE in nearly 40% of 81 infants and toddlers referred for unclear paroxysmal events in our cohort. Non-epileptic staring spells and benign sleep myoclonus were the most common events recorded, followed by shuddering attacks and infantile masturbation. In addition, greater than onehalf of the infants and toddlers had risk factors, raising a concern for epilepsy in the family and prompting the VEEG evaluation, suggesting that paroxysmal non-epileptic seizures may frequently coexist in young children with epilepsy.

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“…focal cortical dysplasia) should not require multiple antiepileptic drug trials before surgical treatment is considered. Children with developmental delay and retardation are also more likely to have medically refractory epilepsy, but their developmental disorders suggest a generalized or multifocal brain disorder, and therefore, possible multifocal or generalized seizures [20]. …”

Section: Medical Intractabilitymentioning

confidence: 99%

Evaluation of Children for Epilepsy Surgery

Olson

2001

Pediatr Neurosurg

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There are three main components to the evaluation of children who are candidates for epilepsy surgery: (1) confirmation of the epileptic nature of the seizures, (2) establishing the medical intractability of the child’s epilepsy and (3) localization of the epileptogenic zone. Differentiating epileptic from nonepileptic events requires careful review of the history and the electroencephalogram. Electroencephalographic recording of the habitual seizures usually suffices to confirm the epileptic or nonepileptic nature of the events. Medical intractability is established by assuring that antiepileptic medications appropriate for the child’s particular epilepsy syndrome have been used and have been titrated to maximum tolerance before being deemed ineffective. Confident localization of the epileptogenic zone requires that multiple findings such as behavior during the seizure, ictal and interictal EEG, and cerebral imaging studies provide data that are convergent with respect to a likely area of seizure onset.

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Clinical Study on Localization-Related Epilepsy in Infancy Without Underlying Disorders

Cited by 9 publications

References 19 publications

Benign Partial Epilepsy in Infancy: Myth or Reality?

Benign Partial Epilepsy in Infancy: Myth or Reality?

Paroxysmal non‐epileptic events in infants and toddlers: A phenomenologic analysis

Evaluation of Children for Epilepsy Surgery

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