Generalized spike-and-wave patterns in children: Clinical correlates

All electroencephalograms performed in our institution between 1980 and 199 0 were reviewed. The clinical characteristics of children with epilepsy and generalized spike-and-wave (SW) patterns were analyzed. The SW patterns we re classified according to their frequency. Electroencephalograms of 154 ch ildren with epilepsy revealed SW patterns. Absence seizures were the most c ommon first seizure, but partial seizures were frequent. More than 40% had several types of seizures. Sixty percent of the epileptic syndromes were ge neralized, but almost 25% were partial. The typical SW pattern was associat ed with absence seizures, a normal examination and computed tomographic sca n, idiopathic generalized epilepsies, monotherapy, freedom from seizures, a nd lack of recurrence. The slow SW pattern was associated with West syndrom e; a younger age at seizure onset; atonic, myoclonic, tonic, and partial si mple seizures; an abnormal examination and computed tomographic scan; crypt ogenic or symptomatic generalized epilepsy or symptomatic partial epilepsy; polytherapy; and poor seizure control. The fast SW pattern was associated with secondary generalized, partial, tonic-clonic, and complex partial seiz ures; a normal computed tomographic scan; cryptogenic partial epilepsy; iso lated seizures; and seizure recurrence. Epilepsy with a typical SW pattern should be considered benign, epilepsy with a slow SW pattern malignant, and epilepsy with a fast SW pattern treacherous. (C) 2000 by Elsevier Science Inc. All rights reserved.