Clinical and video-polygraphic features of epileptic spasms in adults withcortical migration disorder

The International Classification of Epileptic Syndromes considers epileptic spasms to be typical seizures of West syndrome. Literature reports showy t hat spasms are present in epileptic syndromes other than West syndrome bur there are few data on their characteristics in adults. We describe ictal, c linical and video-polygraphic findings in three patients (aged 21, 32 and 5 7 years) with epileptic spasms and with diffuse (case 2), focal right front o-parietal (case 1) and bi-opercular (case 3) pachygyria. Spasms had been p resent since the ages of 1 month, 11 and 27 years respectively. Only one pa tient is mentally retarded. Two of our patients (cases 2 and 3) have partia l seizures. Ictal polygraphic studies showed a positive, diffuse, high amplitude slow w ave activity during spasms, with superimposed fast activity, followed by a diffuse flattening in all cases with a typical muscle pattern. Epileptic spasms, as typically described in West syndrome, can maintain the same semeiological and electroencephalographic features during adulthood i n certain patients with cortical dysplasia.