Abstracts

RATIONALE: Epileptic syndromes with idiopathic etiology and benign outcome have been described in the first year of life: benign partial epilepsy in infancy (Watanabe et al 1997, 1993), benign infantile familial convulsions (Vigevano et al 1992), benign myoclonic epilepsy in infancy (Dravet and Bureau 1981), reflex myoclonic epilepsy in infancy (Ricci et al 1995), absence epilepsy in infancy (De Marco 1980), idiopathic infantile spasms (Vigevano et al 1992, 1993). We wanted to verify the incidence of the different epileptic syndromes of infancy with benign outcome.
METHODS: Between 1994 and 1998, we selected 55 patients (30 males, 25 females) who had presented epilepsy between ages 3 and 18 months and had sufficient data for diagnosing epilepsy. Selection criteria included: onset of epilepsy at age 2-18 months, normal psycho-motor development and neurologic imaging, no identifiable underlying disorders, benign outcome with remission of epilepsy and minimum follow-up of 2 years.
RESULTS: In 23 of the 55 patients, epilepsy corresponded to the criteria of benign partial epilepsy in infancy, with mean age at onset 8.5 months. Eight patients had benign infantile familial convulsions, with mean age at onset 5.5 months. Eleven patients had infantile spasms, mean age at onset 7 months. Six patients had absence epilepsy in infancy, mean age at onset 13.5 months. Four patients had reflex myoclonic epilepsy in infancy, mean age at onset 13 months. Three patients had benign myoclonic epilepsy in infancy, mean age at onset 6.5 months.
Duration of epilepsy varied from a few days to a maximum of 10 months in both untreated patients and patients treated with antiepileptic therapy. We found a family history of epilepsy and/or febrile convulsions in first and second degree relatives in 50.9% of patients, with prevalence of family history, excluding benign familial infantile convulsions, in sporadic benign partial epilepsy as compared to other forms of epilepsy.
CONCLUSIONS: In our case series the most frequent form of epilepsy in the first year of life was benign partial epilepsy. This incidence could be connected to the dramatic clinical picture at onset, which is such that the patients are seen in our hospital in emergency conditions.