The clinical-electrographic expression of infantile seizures

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, recur-rent 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. (c) 2006 Elsevier B.V. All rights reserved.