Early recognition of benign partial epilepsy in infancy

Purpose: The aim of this study is to determine how precisely we can recogni ze the outcome in infants with epilepsy beginning in the first year of life . Methods: We performed a prospective 5-year follow-up study on 63 patients w ho developed epilepsy in the first year of life. We first judged that patie nts met the criteria of "possible benign partial epilepsy in infancy (BPEI) " on enrollment in this study. At 2 years of age, we reevaluated the seizur e and developmental outcome in the patients who were diagnosed as having "p ossible BPEI." We finally judged that patients met the criteria of "definit e BPEI" at age 5 years. "Possible BPEI" was defined as epilepsy meeting all the following conditions: (a) complex partial seizures and/or secondarily generalized seizures; (b) normal psychomotor development and neurologic fin dings before onset; (c) normal interictal electroencephalograms; (d) normal cranial computed tomography (CT) and magnetic resonance imaging (MRI) find ings, and (e) no seizures during the first 4 weeks of life. "Definite BPEI" was defined as epilepsy meeting all the following criteria in addition to those of "possible BPEI": (a) normal psychomotor development beyond age 5 y ears, and (b) no seizures beyond age 2 years. Results: Thirty-two of the 63 patients met the inclusion criteria completel y and were included in the "possible BPEI" group. Twenty-five of the 32 pat ients completed the 5-year follow-up. At age 2 years, four patients were ex cluded From the "possible BPEI" group because of seizure recurrence and/or delayed development. By age 5 years, one had a recurrence of seizures, and another exhibited mildly delayed psychomotor development. We finally diagno sed 19 patients as having "definite BPEI," "Definite BPEI" accounted for 76 % of the patients diagnosed as having "possible BPEI" at the first presenta tion and 90% of those who met the conditions on reevaluation at age 2 years . Conclusions: Recognition of BPEI is possible, to some extent, at the first presentation, and reevaluation at age 2 years is useful for a more precise diagnosis.