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0883073807309771v1
23/5/497    most recent
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First published on January 29, 2008, doi:10.1177/0883073807309771

Journal of Child Neurology 2008;23:497.

A more recent version of this article appeared on May 1, 2008

Article

Migrating Focal Seizures in Infancy: Analysis of the Electroclinical Patterns in 17 Patients

Roberto Horacio Caraballo, MD1*, Elena Fontana, MD2, Francesca Darra, MD2, Laura Cassar, MD1, Francesca Negrini, MD2, Elena Fiorini, MD2, Hugo Arroyo, MD1, Stella Ferraro, MD1, Natalio Fejerman, MD1, and Bernardo Dalla Bernardina, MD2

1 Child Neurology Department, Italian Hospital, Buenos Aires, Argentina
2 University of Verona, Italy

* To whom correspondence should be addressed. E-mail: rhcaraballo{at}arnet.com.ar.


  Abstract
We describe the electroclinical features, therapy, and long-term evolution of 17 patients with migrating focal seizures in infancy, and analyzed the charts of these patients seen between February 1985 and July 2005. Three different electroclinical patterns were recognized: (1) 8 cases with alternating simple focal motor seizures at onset. The ictal electroencephalography (EEG) pattern was characterized by recurrence of rhythmic focal spikes or rhythmic sharp activity in the Rolandic region; (2) 5 cases with complex focal seizures and progressive appearance of polymorphic {delta}-{Theta} activity in 1 temporo-occipital region recurring independently; (3) 4 cases with focal complex seizures with motor manifestations. Ictal EEG showed flattening or fast activity in 1 frontotemporal region followed by unilateral fast poly-spikes in alternating clusters in both hemispheres. The focal seizures were refractory to antiepileptic drugs, and all patients except 3 had severe developmental delay. Migrating focal seizures in infancy is a newly defined and rare, but underrecognized, epileptic encephalopathy.


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