Abstracts

Rationale: The semiology of infants less than two years of age is known to be different from that of adult. We executed this study to describe clinical and ictal characteristics in infants with epilepsy. Methods: The retrospective study was done for the infants with epilepsy (ages: 1-24 months) who were underwent the long-term video EEG monitoring at Samsung medical center from November 1994 to February 2012. Total 56 studies were included. We analyzed the clinical and ictal characteristics of the patients. Results: The seizure occurred prior to 6months of age in 69% of the patients and the etiology was symptomatic in a third of the patients. Twelve seizure types were identified and the frequent seizure semiologies were as follows; infantile spasms (25%), partial seizure (54%), generalized seizures except spasms (21%). Infantile spasms were well correlated with generalized electro-decrement. The myoclonic seizure or atonic seizure was related with electrographically generalized patterns. However, generalized tonic seizure was frequently related to the primary generalized seizure or partial seizure. Generalized tonic seizure with focal onset was mainly arising from frontal areas. The hypomotor seizure showing cyanosis or decreased activities revealed their ictal origins mainly in temporal areas. The hypermotor seizure arose from frontal areas. Unilateral motor seizures or hemi-spasms showed lateralized ictal EEGs. Conclusions: Most of the seizure semiologies in infants were well correlated with the ictal EEGs as in adults. The frontal onset seizures frequently exhibited generalized seizure. The video EEG monitoring was useful to detect and categorize seizures in infants.