Idiopathic generalized epilepsy presenting with hemiconvulsive seizures

Purpose: Unilateral seizures, or hemiconvulsive attacks, are motor seizures with tonic and/or clonic phenomena that involve only one side of the body. Methods: We describe three adolescents who presented with hemiconvulsive se izures and were found to have 3-cps generalized spike and-wave discharges o n ictal and/or interictal EEG. All had normal neuroimaging studies. Two pat ients had been previously treated with carbamazepine, which led to a partia l response in one patient. Results: All three patients, however, are now seizure free on either sodium valproate or a combination of sodium valproate and lamotrigine. We believe the electroclinical diagnosis is that of idiopathic generalized epilepsy. Conclusions: Idiopathic generalized epilepsy presenting with hemiconvulsive seizures has not, to our knowledge, been previously described. However, th e correct diagnosis of an idiopathic generalized seizure disorder, as oppos ed to a partial seizure disorder, has important treatment implications. The possible mechanism of hemiconvulsive seizures in idiopathic generalized ep ilepsy is discussed.