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Differentiating Between Benign and Less Benign: Epilepsy Surgery in Symptomatic Frontal Lobe Epilepsy Associated With Benign Focal Epileptiform Discharges of Childhood

Epilepsy Center, University of Freiburg, Freiburg, Germany, altenm{at}nz.ukl.uni-freiburg.de

Andreas Schulze-Bonhage, MD

Epilepsy Center, University of Freiburg, Freiburg, Germany

Benign focal epileptiform discharges of childhood are a genetically determined electroencephalographic trait. Assessment of their clinical relevance in children with epilepsy may be difficult if imaging reveals a lesion congruent or incongruous with the focus of the benign focal epileptiform discharges of childhood. This article reports a boy with parietooccipital benign focal epileptiform discharges of childhood in whom videoelectroencephalography and magnetic resonance imaging disclosed symptomatic frontal lobe epilepsy. Surgical removal of a focal cortical dysplasia in the left frontal lobe yielded freedom from seizures and positive behavioral and cognitive development. Nocturnal benign focal epileptiform discharges of childhood persisted until puberty (follow-up, 50 months). Early diagnostic differentiation of idiopathic syndromes such as idiopathic benign focal epilepsy of childhood from symptomatic focal epilepsies with a potentially less benign course is important. In symptomatic frontal lobe epilepsy, epilepsy surgery may yield an excellent outcome despite the presence of concurrent benign focal epileptiform discharges of childhood.

Key Words: benign focal epileptiform discharges of childhood • idiopathic benign focal epilepsy of childhood • symptomatic focal epilepsy • epilepsy surgery • frontal lobe • focal cortical dysplasia

Journal of Child Neurology, Vol. 22, No. 4, 456-461 (2007)
DOI: 10.1177/0883073807301919


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