Clinical profile of partial seizures beginning at less than four years of age.
Clinical features of all our 46 patients whose recurrent partial seizures began at age less than or equal to 47 months were studied. Thirty-seven (80%) had motor seizures which were exclusively unilateral in 14 patients, bilaterally synchronous in 8, and both unilateral and bilaterally synchronous in 15. Thirty-three patients (72%) had complex partial seizures (CPS), and 11 patients (24%) had simple partial somatosensory seizures. Clinical seizures were recorded by EEG in 18 patients (39%), and a subclinical (larval) seizure was recorded in 1; those in 10 patients arose from a temporal lobe, 4 were from a frontal lobe, and in 5 they involved two adjacent lobes from onset. Several extra-ictal features reliably indicated lobe or hemisphere of seizure onset. The lobe of principal interictal EEG spikes corresponded to seizure origin in 33 of 34 patients (97%), and regional delta activity corresponded to lobe of seizure origin in 22 of 24 patients (92%). The seizures of all 13 patients with unilateral neurologic signs corresponded to the hemisphere implicated by the deficit. Computed tomography (CT) scan showed lesions in 30 patients (65%) and corresponded to the lobe of seizure onset in 27 of the 30 (90%). Seizures arose primarily from a frontal lobe in 22 of 46 patients (48%), from a temporal lobe in 14 patients (30%), and from an occipital-parietal-posterotemporal region in 6 patients (13%); only the hemisphere of origin could be determined in 4 patients. Cortical developmental abnormalities were the most common known cause (12 patients, 26%); febrile seizures and primary brain tumors occurred in 10 and 8 patients, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Blume
W T
WT
Epilepsy Unit, University Hospital, London, Ontario, Canada.
D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology / Q000601:surgery; D001932:Brain Neoplasms / Q000150:complications; D002675:Child, Preschool; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D005910:Glioma / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007360:Intelligence; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D003294:Seizures, Febrile / Q000150:complications; D014057:Tomography, X-Ray Computed
D000927:Anticonvulsants