MIGRATING PARTIAL SEIZURES IN INFANCY - A MALIGNANT DISORDER WITH DEVELOPMENTAL ARREST

Fourteen infants of both sexes had a previously unreported epileptic c ondition characterized by nearly continuous multifocal seizures. The f irst seizures occurred at a mean age of 3 months, without antecedent r isk factors. At 1 to 10 months, the seizures became very frequent. The y were partial with variable clinical expression, and the EEG showed t hat the discharges randomly involved multiple independent sites, movin g from one cortical area to another in consecutive seizures. Although their topography varied, the EEG ictal pattern of each seizure was ver y similar. It consisted of rhythmic alpha or theta activity which spre ad to involve an increasing area of the cortical surface. Patients reg ressed developmentally and became quadriplegic with severe axial hypot onia. Three patients died at age 7 months and at age 7 and 8 years, re spectively. Seizures were controlled in only 2 patients, and only 3 ch ildren resumed psychomotor development. Extensive investigation failed to determine an etiology, and there was no familial recurrence. Neuro pathological examination of the brain in two cases showed only severe hippocampal neuronal loss and accompanying gliosis.