Ictal ontogeny in Dravet syndrome

Clin Neurophysiol. 2015 Mar;126(3):446-55. doi: 10.1016/j.clinph.2014.06.024. Epub 2014 Jun 30.

Abstract

Objective: To define seizure characteristics of Dravet syndrome (DS) with video-electroencephalographic (EEG) recording in different age groups.

Methods: We reviewed 23 patients with 63 seizures in different age groups: group 1 (0-5years old); group 2 (6-10years old); and group 3 (11 or above).

Results: We included 7, 11 and 5 patients in groups 1, 2, and 3 respectively. Younger children had seizures while awake (p=0.005), provoked seizures (p=0.05), focal seizure semiology (p=0.02) and long seizure duration (p=0.0004). Older children had seizures from sleep (p=0.004), generalized seizure semiology (p=0.01) and short seizure duration (p=0.0007). A generalized ictal discharge was the most commonly observed EEG pattern (15/23, 65%), more frequently found in older children (p=0.01). Ten patients (43%) had unclassified seizures or seizures with discordant EEG results. Postictal EEG suppression was found in 9 (39%).

Conclusion: The phenotype of seizures and ictal EEG patterns in DS vary with age.

Significance: These findings will enhance the recognition of DS in the adolescent population. The incidence of postictal EEG suppression seen in DS is significant because it is a possible biomarker for sudden unexpected death in epilepsy.

Keywords: Channelopathy; Epilepsy; Postictal generalized EEG suppression (PGES); SCN1A; Sudden unexpected death in epilepsy (SUDEP).

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cerebral Cortex / physiopathology*
  • Child
  • Child, Preschool
  • Death, Sudden
  • Electroencephalography
  • Epilepsies, Myoclonic / complications
  • Epilepsies, Myoclonic / genetics
  • Epilepsies, Myoclonic / physiopathology*
  • Female
  • Humans
  • Infant
  • Male
  • NAV1.1 Voltage-Gated Sodium Channel / genetics
  • Seizures / complications
  • Seizures / genetics
  • Seizures / physiopathology*
  • Young Adult

Substances

  • NAV1.1 Voltage-Gated Sodium Channel
  • SCN1A protein, human