title: Migrating focal seizures in infancy: analysis of the electroclinical patterns in 17 patients.
abstract: We describe the electroclinical features, therapy, and long-term evolution of 17 patients with migrating focal seizures in infancy, and analyzed the charts of these patients seen between February 1985 and July 2005. Three different electroclinical patterns were recognized: (1) 8 cases with alternating simple focal motor seizures at onset. The ictal electroencephalography (EEG) pattern was characterized by recurrence of rhythmic focal spikes or rhythmic sharp activity in the Rolandic region; (2) 5 cases with complex focal seizures and progressive appearance of polymorphic delta- activity in 1 temporo-occipital region recurring independently; (3) 4 cases with focal complex seizures with motor manifestations. Ictal EEG showed flattening or fast activity in 1 frontotemporal region followed by unilateral fast poly-spikes in alternating clusters in both hemispheres. The focal seizures were refractory to antiepileptic drugs, and all patients except 3 had severe developmental delay. Migrating focal seizures in infancy is a newly defined and rare, but underrecognized, epileptic encephalopathy.
authors.affiliation: Neurology Department, Hospital de Pediatría Prof Dr Juan P. Garrahan, Combate de los Pozos 1881, CP 1245, Buenos Aires, Argentina. rhcaraballo@arnet.com.ar
authors.forename: Roberto Horacio
authors.initials: RH
authors.lastname: Caraballo
authors.forename: Elena
authors.initials: E
authors.lastname: Fontana
authors.forename: Francesca
authors.initials: F
authors.lastname: Darra
authors.forename: Laura
authors.initials: L
authors.lastname: Cassar
authors.forename: Francesca
authors.initials: F
authors.lastname: Negrini
authors.forename: Elena
authors.initials: E
authors.lastname: Fiorini
authors.forename: Hugo
authors.initials: H
authors.lastname: Arroyo
authors.forename: Stella
authors.initials: S
authors.lastname: Ferraro
authors.forename: Natalio
authors.initials: N
authors.lastname: Fejerman
authors.forename: Bernardo
authors.initials: B
authors.lastname: Dalla Bernardina
mesh_terms: D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012640:Seizures / Q000145:classification* / Q000503:physiopathology*