Epilepsies of neonatal onset: seizure type and evolution

Most neonatal seizures are occasional seizures and not true epilepsy. This study investigates seizure types of true neonatal epilepsies and their evol ution with development. Seventy-five children with epilepsies of onset with in 1 month of life, who were examined between 1970 and 1995, and whose seiz ure types could be confirmed with ictal EEG recordings, were studied. The p atients were followed up for a minimum of 3 years and the evolution of epil eptic syndromes was investigated. Sixty-three (84%) of 75 patients had part ial seizures, while nine had generalized seizures, and only three had both generalized and partial seizures, Twenty-three of 24 neonates with benign f amilial or non-familial neonatal convulsions presented with partial seizure s; these syndromes should not necessarily be categorized into generalized e pilepsy as they are in the present International Classification. Age-depend ent changes were a common feature of symptomatic neonatal epilepsies. Eight een (41%) of 44 patients with symptomatic epilepsies of neonatal onset deve loped West syndrome in infancy. Fifteen (83%) of these 18 patients presente d with symptomatic localization-related epilepsy in the neonatal period. In seven of these 15 patients, West syndrome was followed by localization-rel ated epilepsy. Symptomatic localization-related epilepsy with transient Wes t syndrome in infancy is another type of age-dependent epileptic syndrome.