Electro-clinical-etiological associations of epilepsia partialis continua in 57 Chinese children

Brain Dev. 2017 Jun;39(6):506-514. doi: 10.1016/j.braindev.2017.01.011. Epub 2017 Feb 21.

Abstract

Objective: Epilepsia partialis continua (EPC) was one type of focal status epilepticus. The aim of this study was to analyze the clinical and electroencephalography (EEG) characteristics, and outcome of 57 child-onset patients with EPC according to different etiologies, and further explore the electro-clinical-etiological associations.

Methods: We retrospectively reviewed 57 children diagnosed with EPC in our department over last ten years. Etiology, clinical and EEG data, and outcome were categorized and analyzed.

Results: For the 57 child-onset patients, EPC was caused by different etiologies, including immune-related disease (43.9%), focal lesions (17.5%), inborn errors of metabolism (24.6%), and unknown (14.0%). EEG background abnormalities showed generalized slowing in 45 patients (78.9%) and focal slowing in two patients (3.5%). Nineteen patients (33.3%) presented clear correlation of ictal EEG/EMG and the remaining 38 patients (66.7%) showed no clear correlation of ictal EEG/EMG. Both EEG background activity and ictal EEG/EMG correspondence among different etiologies had statistical significance (P<0.05). The ictal patterns without clear EEG/EMG correspondence in immune-related disease and the ictal patterns with clear EEG/EMG correspondence in focal lesions were more prominent (P<0.05).

Conclusion: This is the first study of child-onset EPC with a large series in a pediatric epilepsy center in China. The most common cause for EPC was immune-related disease. The EEG background activity and the EEG/EMG correspondence might be influenced by the etiologies of EPC to some degree. These findings might guide the direction of EPC diagnosis in conjunction with other examinations.

Keywords: Children; Clinical; Electroencephalography; Epilepsia partialis continua; Etiology.

MeSH terms

  • Adolescent
  • Anticonvulsants / therapeutic use
  • Asian People
  • Brain Injuries / complications*
  • Child
  • Child, Preschool
  • Electroencephalography
  • Electromyography
  • Epilepsia Partialis Continua / drug therapy
  • Epilepsia Partialis Continua / etiology*
  • Epilepsia Partialis Continua / physiopathology*
  • Evoked Potentials, Somatosensory / physiology*
  • Female
  • Humans
  • Immune System Diseases / complications*
  • Infant
  • Longitudinal Studies
  • Male
  • Metabolism, Inborn Errors / complications*
  • Retrospective Studies

Substances

  • Anticonvulsants