OUTCOME IN INFANTS PRESENTING WITH MIGRATING PARTIAL SEIZURES

Objectives: A migrating partial seizure of infancy is a poorly understood entity. The literature suggests that infants presenting with migrating partial seizures tend to have intractable epilepsy and poor developmental outcome (1, 2, 3). We present our experience with patients evaluated at our institution.

Methods: The patients were obtained through a retrospective chart review of 1616 children, who underwent video-EEG monitoring at the Cleveland Clinic between June 2000 and July 2005. The inclusion criteria were as follows: (1) onset of unprovoked, partial seizure before age 6 months; (2) unidentified etiology despite an extensive evaluation; and (3) EEG showing multifocal and bihemispheric ictal foci. Variables analyzed include (1) age, sex, physical examination at presentation and follow-up, age of seizure onset, family history; (2) seizure semiology; (3) number of seizure types; (4) ictal and interictal EEG findings; (5) developmental milestone achieved at follow-up; (6) seizure control at follow-up; and (7) number and types of antiepileptic treatments used. (Patient enrollment and follow up information is ongoing)

Results: In total, 4 patients (all females) met inclusion criteria. The age of presentation ranged from 0–4 months. Follow-up period ranged from 2–12 months. Of these patients, three achieved seizure freedom and were mildly delayed but progressing based on the assessment at follow-up. One patient had refractory seizures and significant developmental delay.

Conclusion: Infants with “migrating partial seizures” may achieve seizure control and good developmental outcomes, contrary to previously reported cases in the literature. 'Multifocoal epilepsy' may therefore be a preferred term for diagnosing such patients in clinical practice. References: (1, 2, 3, 4, 5)