Analysis of ictal electrical-clinical characteristics of focal seizures in children with epilepsy

Abstract

Objective To explore the ictal electrical-clinical features of focal seizures in childhood with epilepsy. Methods The video electroencephalography (VEEG) results of 409 focal seizures of 257 patients with epilepsy during January 2017 to June 2018 in EEG Monitoring Center of Department of Neurology of Hu'nan Children's Hospital, along with their neuroimage results were retrospectively analyzed. Results The main symptoms during the attack period were binocular gaze (202 times), deflection (142 times), asymmetrical tonic (138 times), distortion of mouth (45 times), single or one side limb tonic clonic (42 times), focal abnormal sensation (32 times), autonomic neurological symptoms (92 times), hyperkinetic automatisms (93 times), and hand and/or mouth automatism (92 times), vocalization (68 times) and focal atonia (6 times), focal myoclonus (4 times), and focal tonic (2 times). The above symptoms appeared in a single or combined way. VEEG monitoring showed that the types of seizures were focal seizures (249 times), focal to bilateral tonic clonic seizures (121 times), focal status epilepticus (29 times), and focal seizures with spasm (10 times). Initial pattern of EEG during seizure: regional (188 times), focal (55 times), unilateral (53 times), non-unilateral (71 times) or uncertain (42 times). Inter-episodic EEG activity showed focal discharge (92 cases), multifocal discharge (49 cases), extensive discharge (27 cases) or no discharge (89 cases). In 257 cases, 178 cases (69.26%) were classified as epilepsy syndrome. Benign familial or non-familial infantile seizures was more common (54.26%, 51/94) in the group of age-dependent epilepsy syndrome, frontal lobe epilepsy was more common (62.50%, 50/80) in location related epilepsy. Conclusions The seizure symptoms of focal seizures in children have focal features, and the ictal EEG patterns during the seizure are diverse, which can be associated with multiple epilepsy syndromes. VEEG monitoring is an irreplaceable method for definite diagnosis at present.

DOI:10.3969/j.issn.1672-6731.2019.10.015