Frontal Lobe Epilepsy in Childhood
Abstract number :
1.163
Submission category :
Year :
2001
Submission ID :
3047
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
D.B. Sinclair, MD, FRCP (C), Pediatric Neurology, University of Alberta Hospitals, Edmonton, AB, Canada; K. Aronyk, MD, FRCS (C), Pediatric Neurosurgery, University of Alberta Hospitals, Edmonton, AB, Canada; T. Snyder, PhD, Neuropsychology, University of
RATIONALE: Frontal lobe epilepsy (FLE) is poorly understood. We sought to better characterize FLE in childhood.
METHODS: We reviewed patients admitted to the Pediatric Epilepsy Monitoring Unit (PEMU) at the University of Alberta with a final diagnosis of FLE. Age, seizure semiology, EEG, MRI and outcome were examined.
RESULTS: Twenty-one patients, 13 males and 8 females were studied. Age of onset was variable (10 months to 16 years), with a mean of 7.5 years. There was a family history of epilepsy in 9 patients. Seizures were brief (30 seconds-2 minutes), stereotypic, nocturnal (17/21) and frequent (3-22 night). Clinical features included explosive onset, screaming, agitation, stiffening, kicking or bicycling of the legs and incontinence. The correct diagnosis was not suspected in any patient before referral. The initial diagnosis being sleep disturbance (9), psychiatric problems (6) or other seizure types (6). Interictal EEG was usually normal (17/21). LTV EEG demonstrated frontal (8) or bifrontal epileptic discharge (12). MRI was normal in most patients (17/21). Seizure control was difficult with only half the patients (10/21) being controlled on carbamazepine or valproic acid. Three intractable patients went on to epilepsy surgery and became seizure free.
CONCLUSIONS: FLE in childhood is a distinct epilepsy syndrome with characteristic features independent of etiology or age. The seizures are brief, stereotypic, nocturnal and frequent. EEG and MRI are usually normal. The condition is often misdiagnosed as a sleep disorder or psychiatric problem. Seizures are difficult to control but may respond to carbamazepine, valproic acid or epilepsy surgery.