The ontogeny of partial seizures in infants and young children

Purpose: To describe the clinical manifestations of partial seizures in the pediatric Population as a function of age. Methods: Using the database of the pediatric epilepsy monitoring unit (Chil dren's Hospital of New York), clinical and EEG characteristics of partial s eizures were distributed by age groups 0-2, 2-6, and 6+ years for 123 patie nts who had at least one such seizure with a clear EEG correlate during the ir admission. chi (2) tests for trend were used to examine clinical and EEG features as a function of age. Results: The frequency of aura, limb automatisms. dystonic posturing. secon dary generalization, and unresponsiveness increased with age, whereas asymm etric clonus and symmetric tonic posturing decreased with age. There were n o clear changes in the types of EEG ictal patterns observed with age; howev er. partial seizures emanating from the anterior regions of the brain tende d to increase with age, whereas those from the posterior regions tended to decrease with age. Conclusions: Important differences exist in the clinical expression of seiz ures between young children and adults. These findings will contribute to a better understanding of ictal ontogeny that will promote more accurate cla ssification of seizures and of the epilepsies in young patients. Such effor ts can be used to identify young patients for focal epilepsy surgery and to select appropriate anticonvulsive medications.