Idiopathic generalized epilepsy presenting with hemiconvulsive seizures.
OBJECTIVE
Unilateral seizures, or hemiconvulsive attacks, are motor seizures with tonic and/or clonic phenomena that involve only one side of the body.


METHODS
We describe three adolescents who presented with hemiconvulsive seizures and were found to have 3-cps generalized spike-and-wave discharges on ictal and/or interictal EEG. All had normal neuroimaging studies. Two patients had been previously treated with carbamazepine, which led to a partial response in one patient.


RESULTS
All three patients, however, are now seizure free on either sodium valproate or a combination of sodium valproate and lamotrigine. We believe the electroclinical diagnosis is that of idiopathic generalized epilepsy.


CONCLUSIONS
Idiopathic generalized epilepsy presenting with hemiconvulsive seizures has not, to our knowledge, been previously described. However, the correct diagnosis of an idiopathic generalized seizure disorder, as opposed to a partial seizure disorder, has important treatment implications. The possible mechanism of hemiconvulsive seizures in idiopathic generalized epilepsy is discussed.
Kiley
M A
MA
National Hospital of Neurology and Neurosurgery, Queen Square, London, UK.
Smith
S J
SJ
Sander
J W
JW
D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D015897:Comorbidity; D004569:Electroencephalography / Q000706:statistics & numerical data*; D017034:Epilepsy, Frontal Lobe / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D004829:Epilepsy, Generalized / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D020938:Epilepsy, Partial, Motor / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use
D000927:Anticonvulsants; D014227:Triazines; D014635:Valproic Acid; D000077213:Lamotrigine