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

Ictal ontogeny in Dravet syndrome.

Author information

1
Epilepsy Center, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
2
Epilepsy Center, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Electronic address: LLaux@luriechildrens.org.

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)

PMID:
25046982
DOI:
10.1016/j.clinph.2014.06.024
[Indexed for MEDLINE]

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