title: Clinical profile of partial seizures beginning at less than four years of age.
abstract: 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)
authors.affiliation: Epilepsy Unit, University Hospital, London, Ontario, Canada.
authors.forename: W T
authors.initials: WT
authors.lastname: Blume
mesh_terms: 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
chemical_list: D000927:Anticonvulsants