title: Early classification of childhood focal idiopathic epilepsies: is it possible at the first seizure?
abstract: OBJECTIVE
  To evaluate the possibility of early syndrome classification of idiopathic partial epilepsies in children at the first seizure.
  
  
  METHODS
  In this observational study we prospectively evaluated 298 patients, aged between 1 month and 17 years and consecutively referred for the first unprovoked focal seizure. The whole cohort included 133 patients; the final analysis was carried out on 107 (59 males) individuals. Age at the first seizure ranged between 2.3 and 13.0 years. Clinical and EEG data of all patients were independently reviewed by two medical doctors. Patients were followed-up for at least 5 years, with a mean period of follow-up of 6.9 years.
  
  
  RESULTS
  After the first seizure, a specific syndrome could be diagnosed in eighty (74.7%) children. In particular, Childhood Epilepsy with Centro-Temporal Spikes (CECTS) 42.9% of cases, Panayiotopoulos Syndrome (PS) 28.9%, idiopathic childhood occipital epilepsy of Gastaut (ICOE-G) 2.8%. Unclassified cases were 25.4%. At the end of the follow-up, the diagnosis was confirmed in 72 of 80 children (90%): BCECTS 89% of patients, PS 90% and ICOE-G 100%: among the unclassified cases, in 11 patients (40.7%) the diagnosis did not change, whereas 16 patients (59.3%) evolved into other syndromes or into atypical forms.
  
  
  CONCLUSIONS
  At the onset an initial diagnosis is possible in the majority of cases; epilepsy syndromes can be identified at the time of the initial diagnosis and at follow up this diagnosis has not to be revised in 90% of the cases.
authors.affiliation: Pediatric Unit, San Paolo Hospital, Savona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gaggero
authors.affiliation: Servizio Epidemiologia e Biostatistica, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Pistorio
authors.affiliation: ASL 3 Genova, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Pignatelli
authors.affiliation: Department of Pediatrics, University of Chieti, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Department of Child Neuropsychiatry, "G Gaslini" Institute, Italy.
authors.forename: Maria Margherita
authors.initials: MM
authors.lastname: Mancardi
authors.affiliation: Department of Child Neuropsychiatry, "G Gaslini" Institute, Italy.
authors.forename: Maria Giuseppina
authors.initials: MG
authors.lastname: Baglietto
authors.affiliation: Pediatric Neurology and Muscolar Diseases Unit, Department of Neurosciences, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, "G Gaslini" Institute, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Striano
authors.affiliation: Department of Pediatrics, University of Perugia, Italy. Electronic address: averrott@unich.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Verrotti
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D042241:Early Diagnosis; D004569:Electroencephalography / Q000379:methods; D004828:Epilepsies, Partial / Q000145:classification* / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D012640:Seizures / Q000175:diagnosis*
keywords: Childhood epilepsy; Classification; First seizure; Idiopathic epilepsy; Partial epilepsy; Unclassified cases