title: Seizures in fetal alcohol spectrum disorders: evaluation of clinical, electroencephalographic, and neuroradiologic features in a pediatric case series.
abstract: Seizures are observed with a frequency of 3-21% in children with fetal alcohol spectrum disorders (FASD). However, clinical, neuroradiologic, and electroencephalography (EEG) features are poorly described. In this study, 13 patients with FASD and epilepsy or seizures were identified retrospectively from the databases of seven Italian pediatric neurology divisions. Eleven children were affected by epilepsy, and two had at least one documented seizure. Both generalized and focal seizures were observed. EEG showed diffuse or focal epileptic activity; two children developed electric status epilepticus during sleep (ESES). Structural brain anomalies, including polymicrogyria, nodular heterotopia, atrophy, and Arnold-Chiari type 1 malformation, were discovered in almost 50% of patients. Control of seizures was not difficult to obtain in 11 cases; one patient showed pharmacoresistant epilepsy. EEG and clinical follow-up are recommended in children with FASD and epilepsy, since severe conditions requiring aggressive treatment, such as in ESES, may develop. Neuroradiological evaluation is warranted because several types of brain anomalies could be associated with maternal alcohol consumption during pregnancy. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.
authors.affiliation: Child Neurology Division, Department of Pediatrics, Sapienza University of Roma, Roma, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Nicita
authors.forename: Alberto
authors.initials: A
authors.lastname: Verrotti
authors.forename: Dario
authors.initials: D
authors.lastname: Pruna
authors.forename: Pasquale
authors.initials: P
authors.lastname: Striano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Capovilla
authors.forename: Salvatore
authors.initials: S
authors.lastname: Savasta
authors.forename: Maria Valentina
authors.initials: MV
authors.lastname: Spartà
authors.forename: Pasquale
authors.initials: P
authors.lastname: Parisi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Parlapiano
authors.forename: Luigi
authors.initials: L
authors.lastname: Tarani
authors.forename: Alberto
authors.initials: A
authors.lastname: Spalice
mesh_terms: D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D004829:Epilepsy, Generalized / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging; D011859:Radiography; D012189:Retrospective Studies; D012640:Seizures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology
keywords: Alcohol-related neurodevelopmental disorders; Electroencephalography; Epilepsy; Fetal alcohol spectrum disorder; Fetal alcohol syndrome; Partial fetal alcohol syndrome