Age Dependent Generalized EEG Findings in Pediatric Focal Epilepsy

Background: Generalized features in the clinical semiology and EEG may occur in young children with focal epilepsy as a maturational phenomenon. Study Goals and Methods: The interictal, ictal video EEG, MRIs and clinical data from 5 patients with focal epilepsy evaluated for epilepsy surgery were analyzed. Age of onset and at evaluation, localization of the epileptogenic lesion, electrographic focus and surgical outcome were noted. Results: All patients had early onset catastrophic epilepsy, evaluation occurred under age 6 years. Three lesions were frontal, 2 temporal. Histology showed developmental pathology. EEG discharges were multifocal and generalized once with 3Hz spike waves. Post-surgery all patients became seizure free and the EEG pathology remitted. Conclusion: Propagated epileptiform activity may occur in focal epilepsy in young children as a maturational phenomenon. Surgical resection of the primary epileptic lesion may result in good seizure control. Generalized EEG findings should not be considered a contraindication to surgical treatment in these cases.