title: Epileptic spasms preceded by partial seizures with a close temporal association.
abstract: OBJECTIVE
  To investigate the distinctive features of patients with West syndrome who had partial seizures followed by epileptic spasms (PS-ES).
  
  
  METHODS
  We examined 45 patients with West syndrome whose epileptic spasms were recorded with simultaneous video-electroencephalography (EEG) monitoring between 1982 and 1996. We investigated the patients who had PS-ES and compared the PS-ES patients with the 37 patients without PS-ES.
  
  
  RESULTS
  Of the 45 patients who had epileptic spasms in clusters (ES) and hypsarrhythmia on the interictal EEG, eight (17%) had ES preceded by partial seizures (PS) with a close temporal association. Seven of these eight were female patients. The underlying disorders were tuberous sclerosis (one patient), Aicardi syndrome (one), nonketotic hyperglycinemia (one), and focal cortical dysplasia (one). The etiology was unknown in the remaining four patients, but was suspected to be of prenatal origin in three. Three types of seizure sequence were identified: PS followed several seconds later by ES (two patients), alternating PS and ES starting with PS (three), and PS gradually replaced by ES with overlapping of the two (three). PS-ES disappeared or was replaced by other types of seizures in 1-34 months. Six patients could not walk, and all patients could not speak any sentences at age 3 years.
  
  
  CONCLUSIONS
  Compared with patients without PS-ES, those with PS-ES more often had organic brain lesions of prenatal origin, other types of seizures before the onset of ES, asymmetric hypsarrhythmia on the EEG, and poor psychomotor outcome.
authors.affiliation: Department of Pediatrics, Nagoya University School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kubota
authors.forename: K
authors.initials: K
authors.lastname: Aso
authors.forename: T
authors.initials: T
authors.lastname: Negoro
authors.forename: A
authors.initials: A
authors.lastname: Okumura
authors.forename: J
authors.initials: J
authors.lastname: Natsume
authors.forename: H
authors.initials: H
authors.lastname: Takada
authors.forename: K
authors.initials: K
authors.lastname: Itomi
authors.forename: K
authors.initials: K
authors.lastname: Watanabe
authors.forename: N
authors.initials: N
authors.lastname: Yamamoto
mesh_terms: D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004569:Electroencephalography / Q000706:statistics & numerical data*; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013036:Spasms, Infantile / Q000175:diagnosis* / Q000453:epidemiology; D014743:Videotape Recording