Abstracts

Rationale: Paroxysmal motor events are common clinical symptoms of infants visiting pediatric neurology clinic. Since the heterogeneous clinical symptoms as well as the difficulty in interpreting infant electroencephalograms (EEG), differential diagnosis of paroxysmal motor events from epileptic events is challenging. A detailed consultation to identify key elements of the patient’s history may narrow the possibilities, often helpful to make a diagnosis. The purpose of this study is to investigate the clue for the diagnosis, laboratory result, EEG, brain magnetic resonance (MR) findings as a potential predictor for diagnosis of epilepsy in infants with paroxysmal motor events. Methods: This is a retrospective study performed from January 2008 to December 2009 at Asan Medical Center, with the patients presented with paroxysmal motor events at infancy. The electrical medical record was reviewed by two pediatric neurologists. Patient’s demographics, medical history, clinical characteristics associated with a specific circumstance, heterogeneous motor symptoms, laboratory findings, EEG, brain magnetic resonance imaging (MRI) and final diagnosis were analyzed. Results: A total of 111 infants with paroxysmal motor events were enrolled. Thirty-four patients (30.6%) were finally diagnosed with epilepsy while 77 (69.4%) patients were proven to be non-epileptic paroxysmal motor events (NEPMs). Demographic data and variable motor symptoms were not significantly associated with their final diagnosis. However, the patients with NEPMs were more likely to be associated with specific circumstances such as feeding, sleeping, crying, and some type of stimulation (72/77, 93.5% vs 16/34, 47.1%, P< 0.001). Patients diagnosed with epilepsy had more abnormalities in EEG (23/30 epilepsy, 67.6% vs. 1/77 NEPMs, 1.3%, P < 0.001) and abnormal brain MRI findings (14/30 epilepsy, 46.7% vs. 4/25 NEPMs, 16%, P < 0.001). Conclusions: When an infant visited with paroxysmal motor events, NEPMs were more common than epilepsy. Non-specific clinical situations for motor symptoms as well as abnormal EEG and brain MRI findings could help the eventual diagnosis of epilepsy. A further prospective study will help to show the importance of clinical manifestations as a potential predictor of epilepsy in this age group of patients. Funding: No funding