Post-Ictal Paresis in Benign Rolandic Epilepsy of Childhood.
Abstract number :
D.11
Submission category :
Year :
2000
Submission ID :
1119
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Alper Dai, Arie Weinstock, Akila Venkatarman, Susan L Kerr, Michael E Cohen, State Univ of New York at Buffalo, Buffalo, NY.
RATIONALE: To identify clinical and EEG findings of post-ictal Todd's paresis (PIP) in Benign Rolandic Epilepsy of Childhood (BREC) with central/centrotemporal sharp waves. METHODS: A total of 68 patients (30 girls and 38 boys) with EEG and clinical criteria characteristic of BREC were identified. The symptomatology of the seizures and the presence of post ictal paresis were investigated. All children underwent neurological evaluation. Clinical and EEG findings, including localization of central/centrotemporal sharp waves (C/CT SW), the presence of unilateral or bilateral (synchronous or independent) EEG activity and the presence of horizontal dipole were assessed. RESULTS: 6 (3 girls, 3 boys) of 68 patients were found to have post ictal transient motor deficits, suggestive of Todd's paresis. All patients had partial motor seizures involving predominantly the upper extremities, and to a lesser degree the lower extremities and face. Three right handed patients also experienced brief aphasia with right post ictal paresis. In all 6 patients, the motor deficit resolved within 30 minutes. Follow up neurological examination was non-focal in all patients. 5 of the 6 patients experienced PIP only once, and one patient had two such episodes of PIP. The EEG in all patients demonstrated central and/or centrotemporal sharp waves. In 5 patients, C/CT SW were bilateral and independent and in 1 patient the Rolandic sharp waves were unilateral. A horizontal dipole with positivity at the central region was found in all patients using an average montage. Head MRI scans in all patients were normal. CONCLUSIONS: In this study, we found a 9% association of post ictal paresis with BREC and 50% of them were found to have brief post ictal aphasia. The post ictal paresis and aphasia were clinically benign. The EEG was characteristic for BREC with bilateral asynchronous discharges in five out of six patients (83%) and presence of a horizontal dipole in all patients. The presence of a post ictal paresis should not exclude the diagnosis of BREC.