Unique clinical phenomenology can help distinguish primary from secondary generalized seizures in children.
The physical manifestations a seizure produces provide critical information. It is assumed that all generalized convulsions are ostensibly the same, regardless of whether they are primary or secondary generalized seizures. We undertook a pilot study to determine if the clinical phenomenology of secondary generalized seizures in children with epilepsy is different from classic descriptions of generalized tonic-clonic convulsions. A data capture sheet was created and applied to the video-electroencephalographic (EEG) records of 64 secondary generalized seizures from 13 children with intractable and/or refractory epilepsy. Many features of secondary generalized seizures were different from traditional descriptions of generalized convulsions. In 100% of cases, the mouth either remained open or repeatedly opened and closed rather than slamming shut. In 77% of cases, a variety of late motor activities were seen to occur after the seizure activity had ceased and the EEG record was quiet. The clinical features of a generalized convulsion in a child, especially mouth opening and late motor events, can be useful in establishing the origin as either focal or primary generalized.
Kirton
Adam
A
Division of Pediatric Neurology, Department of Pediatrics, Alberta Children's Hospital, Faculty of Medicine, University of Calgary, Calgary, AB. adam.kirton@calgaryhealthregion.ca
Darwish
Husam
H
Wirrell
Elaine
E
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000379:methods* / Q000706:statistics & numerical data; D004829:Epilepsy, Generalized / Q000175:diagnosis* / Q000503:physiopathology; D004830:Epilepsy, Tonic-Clonic / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009043:Motor Activity / Q000502:physiology; D009055:Mouth / Q000502:physiology; D010865:Pilot Projects; D012189:Retrospective Studies; D012640:Seizures / Q000503:physiopathology*; D014741:Video Recording