1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-14-77-a 10.15844/pedneurbriefs-14-10-7 Seizure Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Early Diagnosis of Epilepsy Syndromes http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 10 2000 01 04 2016 14 10 77 77 Copyright: © 2000 The Author(s) 2000 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How well can epilepsy syndromes be identified at diagnosis? A reassessment 2 years after initial diagnosis

The classification of epilepsy syndromes made initially on the basis of information at time of diagnosis was compared to that made 2 years later in a cohort of 613 children, followed by participating physicians in Connecticut, between 1993 and 1997.

 Diagnosis Epilepsy Syndromes Carbamazepine

The classification of epilepsy syndromes made initially on the basis of information at time of diagnosis was compared to that made 2 years later in a cohort of 613 children, followed by participating physicians in Connecticut, between 1993 and 1997. After 2 years, syndrome classifications were the same in 86% of the cohort. The diagnosis was changed in 10% (mainly incomplete syndromes), and syndrome evolution, mainly West to Lennox-Gastaut, occurred in 4%. Significant changes were rare. [1]

COMMENT. The identification of epileptic syndromes, for the most part, may be made accurately at the time of the initial presentation and diagnosis. Changes in diagnosis at follow-up, necessary in only 14%, are explained by difficulties in classification of incomplete syndromes and the evolution of West to Lennox-Gastaut syndomes with age and maturation.

Epileptic syndromes posing problems in diagnosis. Hirsch E et al (Strasbourg, France) review the heterogeneous nature and clinical management of partial epilepsies and incomplete syndromes. BECTS are the most common idiopathic localization-related epilepsy, and may be triggered by carbamazepine in some cases. Primary reading epilepsy and idiopathic occipital lobe epilepsies with photosensitivity are an overlap of idiopathic localization-related and generalized epilepsies, and respond to sodium valproate. Other variants of idiopathic localization-related epilepsies include autosomal dominant nocturnal frontal lobe epilepsy and benign familial infantile convulsions. AED resistance can be due to errors in diagnostic classification of these epilepsy syndromes. EEG-video evaluation may be necessary in refractory seizures. [2]

Post-ictal paralysis in BECTS. Dai A et al (State University of New York, Buffalo, NY) found a 9% association of post-ictal paresis among 68 children with benign rolandic epilepsy, and 50% had brief post-ictal aphasia. Todd’s paresis and aphasia do not exclude the diagnosis of BREC, and these transient complications are clinically benign. [3]

Berg AT Shinnar S Levy SR Testa FM Smith-Rapaport S Beckerman B How well can epilepsy syndromes be identified at diagnosis? A reassessment 2 years after initial diagnosis Epilepsia 2000 Oct 41 10 1269 1275 10.1111/j.1528-1157.2000.tb04604.x 11051121 Hirsch E de Saint-Martin A Arzimanoglou A New insights into the clinical management of partial epilepsies Epilepsia 2000 41 Suppl 5 S13 S17 10.1111/j.1528-1157.2000.tb06042.x 11045435 Dai A Abstracts from the Annual Meeting of the AES, Los Angeles, CA, Dec 1-6, 2000 Epilepsia 2000 Oct 4 suppl 7 88