Absence seizures in the first 3 years of life: an electroclinical study of 46 cases.
OBJECTIVE
Early onset absence seizures have been considered a rare heterogeneous group with a poor prognosis. Only few patients may be categorized into well-known syndromes. We have evaluated electroclinical features, evolution, and the nosologic boundaries of early onset absence seizures.


METHODS
Forty-six neurologically normal patients with absence seizures associated with bilateral, synchronic, or asynchronic, and symmetric or asymmetric spike-and-wave paroxysms with onset in the first 3 years of life were included. Patients with abnormal neurologic examination and brain imaging were excluded from the study.


RESULTS
In our study, 39 patients met the clinical and electroencephalography (EEG) criteria of well-defined epileptic syndromes. Childhood absence epilepsy was found in 11 patients, benign myoclonic epilepsy in infancy in 18 patients, eyelid myoclonic epilepsy in 4, and epilepsy with myoclonic absences in 6. We did not find clinical and EEG criteria of well-recognized epileptic syndromes in seven children. Nine of 11 patients with simple absence seizures became seizure free. All these patients had normal neurologic and neuropsychological evaluations. Of the 35 patients who had absence seizures associated with myoclonic seizures, 20 became seizure free. Fifteen of 35 children continue having seizures. At the last visit, 20 of these 35 patients had normal neurologic and neuropsychological evaluations, 11 presented with mild mental retardation, and 4 with severe mental retardation.


CONCLUSIONS
Epilepsies with absence seizures of early onset are relatively uncommon. Most of the patients had well-defined epileptic syndromes with a variable evolution. The evolution depended on the epileptic syndromes.
Department of Neurology, Hospital Nacional de Pediatría Prof Dr Juan P Garrahan, Buenos Aires, Argentina. rhcaraballo@arnet.com.ar
Roberto Horacio
RH
Caraballo
Francesca
F
Darra
Elena
E
Fontana
Roberto
R
Garcia
Eduardo
E
Monese
Bernardo
B
Dalla Bernardina
D000328:Adult; D017668:Age of Onset; D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000473:pathology; D002675:Child, Preschool; D018450:Disease Progression; D004569:Electroencephalography; D004831:Epilepsies, Myoclonic / Q000503:physiopathology / Q000523:psychology; D004827:Epilepsy / Q000453:epidemiology; D004832:Epilepsy, Absence / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D017029:Epilepsy, Complex Partial / Q000503:physiopathology / Q000523:psychology; D005190:Family; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000150:complications; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D003294:Seizures, Febrile / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D014888:Wechsler Scales; D055815:Young Adult
D000927:Anticonvulsants