PubMed · 16383163
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
David A Steven, Samuel Wiebe. 2006. Evaluating surgery effectiveness.. https://pubmed.ncbi.nlm.nih.gov/16383163/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
PURPOSE: To describe the seizures in infants with epilepsy syndromes undetermined whether focal or generalized. METHODS: This was a retrospective video-EEG study of seizures recorded at Children's Memorial Hospital (CMH), Chicago, IL, in infants diagnosed with epilepsy syndromes undetermined whether focal or generalized. RESULTS: Of 69 infants with seizures recorded, 23 (33%) had epilepsies undetermined whether focal or generalized with both generalized and focal seizures, 17 of which (25% of the total) had epilepsies with both focal and generalized seizures not further specified. The predominant seizure type was spasms with focal seizures. CONCLUSIONS: We propose several small modifications to the existing 1989 ILAE epilepsy syndrome classification: epilepsies with both focal and generalized seizures could be re-labeled "pleomorphic epilepsies" for simplicity and should include idiopathic and symptomatic subgroups. We believe these epilepsies are not uncommon in the group of infants with intractable seizures and may have yet to be discovered metabolic and genetic determinants.
PURPOSE: To describe the electro-clinical expression of seizures in infants (1-24 months). METHODS: We reviewed the video and EEG files of all infantile seizures recorded at Children's Memorial Hospital, Chicago, IL, from 2000 to 2005. Electrographic and clinical features were entered into separate databases. The electrographic component of the database analyzed the predominant location and pattern at onset, the evolution, the termination and the duration of each seizure. The clinical data sheet included 25 items. Each seizure was assigned to a specific category according to its most prominent clinical feature, according to the opinion of both observers. RESULTS: Thirteen seizure types were identified. In a significant number of cases, the EEG correlate could not be predicted on the basis of clinical observations only. Generalized seizures were observed, on average, at a later age than focal seizures. Excluding spasms, the mean duration of seizures was short (36 s). CONCLUSIONS: The results of this study are useful in describing the clinical and electrographic repertoire of infantile seizures. The findings show that video-EEG recordings in infants with frequent, recurrent seizures are useful by fully allowing complete recognition of subtle events, and in fully categorizing the true nature of the ictus. Video-EEG findings and accurate seizure classification may add fundamental information with regards to epilepsy syndrome diagnosis and specific treatment options, including surgery.
Although many observations in patients with this intriguing type of epilepsy have been described and detailed studies have been performed, only a few meet the current criteria of class 1 or 2 evidence-based studies. In general, the selection bias is due to studying a referral population instead of the general population, and to different age and sex distributions of the subjects under study. Comparing the various studies is often difficult, because of differences in the populations studied (single seizures, epilepsy centre population, etc.), but also because of different methods (photic stimulator, flash frequencies, eye conditions, etc.) and the terminology used. Finally, and most crucial, in many studies there is often no information on how the data were actually obtained (EEG or clinical data or both?). The popular term "photosensitive" is used widely and applied to patients with a history of visually induced seizures, with and without a photoparoxysmal response (PPR), and to those with only a PPR. An overview of the "hard" data is given with future needs for a better understanding of this type of epilepsy and for improving the endophenotype for genetic research. It is important to standardise the studies as much as possible and describe in detail the methodology of the study, taking at least the above variables into account.