The ontogeny of partial seizures in infants and young children.
OBJECTIVE
To describe the clinical manifestations of partial seizures in the pediatric population as a function of age.


METHODS
Using the database of the pediatric epilepsy monitoring unit (Children's Hospital of New York), clinical and EEG characteristics of partial seizures were distributed by age groups 0-2, 2-6, and 6+ years for 123 patients who had at least one such seizure with a clear EEG correlate during their admission. chi2 tests for trend were used to examine clinical and EEG features as a function of age.


RESULTS
The frequency of aura, limb automatisms, dystonic posturing, secondary generalization, and unresponsiveness increased with age, whereas asymmetric clonus and symmetric tonic posturing decreased with age. There were no clear changes in the types of EEG ictal patterns observed with age; however, partial seizures emanating from the anterior regions of the brain tended to increase with age, whereas those from the posterior regions tended to decrease with age.


CONCLUSIONS
Important differences exist in the clinical expression of seizures between young children and adults. These findings will contribute to a better understanding of ictal ontogeny that will promote more accurate classification of seizures and of the epilepsies in young patients. Such efforts can be used to identify young patients for focal epilepsy surgery and to select appropriate anticonvulsive medications.
Nordli
D R
DR
Epilepsy Center, Children's Memorial Hospital, Chicago, Illinois, USA. dnordli@childrensmemorial.org
Kuroda
M M
MM
Hirsch
L J
LJ
D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use; D001332:Automatism / Q000175:diagnosis / Q000503:physiopathology; D001921:Brain / Q000254:growth & development / Q000503:physiopathology*; D002540:Cerebral Cortex / Q000254:growth & development / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004421:Dystonia / Q000175:diagnosis / Q000503:physiopathology; D004569:Electroencephalography / Q000706:statistics & numerical data*; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D004827:Epilepsy / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008991:Monitoring, Physiologic / Q000706:statistics & numerical data
D000927:Anticonvulsants