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DOI: 10.1055/s-2008-1062705
© Georg Thieme Verlag KG Stuttgart · New York
Seizure Semiology of Lesional Frontal Lobe Epilepsies in Children
Publication History
received 22.08.2007
accepted 19.01.2008
Publication Date:
06 May 2008 (online)
![](https://www.thieme-connect.de/media/neuropediatrics/200706/lookinside/thumbnails/10.1055-s-2008-1062705-1.jpg)
Abstract
The aim of the study was to analyse the semiology of seizures in children with frontal lobe epilepsy (FLE) and to compare them with other paediatric cohorts described in the literature as well as with adult counterparts. We analysed 174 registered seizures of 18 cases under 12 years with lesional epilepsy whose frontal origin was defined by the concordance of neuroimaging and ictal electrographic findings, and confirmed by surgery in the six cases operated on. Seizures were generally short, with a high daily frequency and usually related to sleep. The most characteristic semiological pattern consisted of complex motor seizures, particularly hypermotor. Often seizures corresponded to a mixture of different semiological patterns (tonic, gelastic, automotor, hypermotor, versive) presenting in the same seizure, often as a unique type in the same patient. With regard to several aspects the semiology of FLE in our cohort looks like that reported in adult series, in particular as to the frequency of complex motor seizures. However, our cohort was also characterised by a more protean array of seizure semiology, stressing the occurrence of seizures typically present in adults (versive and complex motor) and of some seizure patterns more characteristic in children such as epileptic spasms; moreover, the rare occurrence of secondarily generalised tonic clonic seizures (SGTCS) was confirmed.
Key words
frontal lobe epilepsy - seizure semiology - childhood
References
- 1 Bartolomei F, Trébuchon A, Gavaret M, Régis J, Wendling F, Chauvel P. Acute alteration of emotional behaviour in epileptic seizures is related to transient desynchrony in emotion-regulation networks. Clin Neurophysiol. 2005; 116 2473-2479
- 2 Chassagnon S, Minotti L, Kremer S, Verceuil L, Hoffmann D, Benabid AL. et al . Restricted frontomesial epileptogenic focus generating dyskinetic behavior and laughter. Epilepsia. 2003; 44 859-863
-
3 Chauvel P, Kliemann F, Vignal JP. et al .
The clinical signs and symptoms of frontal lobe seizures; phenomenology and classification. In: Jasper HH, Riggio S, Goldman-Rakic (Eds). Epilepsy and the functional anatomy of the frontal lobe. New York: Raven Press 1995: 115-125 - 4 Chugani HT, Phelps ME, Mazzotta JC. Positron emission tomography study of human brain development. Ann Neurol. 1987; 22 487-497
- 5 Chugani HT, Shields WD, Shewmon DA, Olson DM, Phelps ME, Peacock WJ. Infantile spasms: I. PET identifies focal cortical dysgenesis in cryptogenic cases for surgical treatment. Ann Neurol. 1990; 27 406-413
- 6 Cusmai R, Dulac O, Diebler C. Lésions focales dans les spasmes infantile. Rev Electroencephalogr Neurophysiol Clin. 1988; 18 235-241
-
7 Dravet C.
Generalized epilepsies and frontal lobe epilepsies in children. In: Beaumanoir A et al. (Eds). Frontal lobe seizures and epilepsies in children. Montrouge (France): John Libbey 2003: 121-132 -
8 Dulac O, Rathgeb J-P, Plouin P.
Frontal lobe epilepsy in infancy. In: Beaumanoir A et al. (Eds). Frontal lobe seizures and epilepsies in children. Montrouge (France): John Libbey 2003: 107-111 - 9 Fogarasi A, Janszky J, Faveret E, Pieper T, Tuxhorn I. A detailed analysis of frontal lobe seizures semiology in children younger than 7 years. Epilepsia. 2001; 42 80-85
- 10 Fogarasi A, Tuxhorn I, Hegyi M, Janszky J. Predictive clinical factors for the differential diagnosis of childhood extratemporal seizures. Epilepsia. 2005; 46 1280-1285
- 11 Fogarasi A, Janszky J, Tuxhorn I. Ictal emotional expressions of children with partial epilepsy. Epilepsia. 2007; 48 120-123
- 12 Garcia A, Gutiérrez MA, Barrasa J, Herranz JL. Cryptogenic gelastic epilepsy of frontal lobe origin: a paediatric case report. Seizure. 2000; 9 297-300
- 13 Giroud M, Fayolle H, Gras P, Vion P, Baudoin N, Brunotte F. et al . So-called generalized epilepsy in children leading to frontal epilepsy with a frontal syndrome in childhood: a clinical, EEG and radiological study of 10 cases. Neurol Research. 1993; 15 299-303
-
14 Gobbi G, Frattini D, Boni A. et al .
Spasms outside West syndrome. In: Guzzetta F, Dalla Bernardina B, Guerrini R (Eds). Progress in epileptic spasms and West syndrome. Montrouge (France): John Libbey 2007: 69-80 - 15 Harvey AS, Hopkins IJ, Bowe JM, Cook DJ, Shield LK, Berkovic SF. Frontal lobe epilepsy: clinical seizure characteristics and localization with ictal 99mTc-HMPAO SPECT. Neurology. 1993; 43 1966-1980
- 16 Holmes GL, Moshe SL. Consequences of seizures in the developing brain. J Epilepsy. 1990; 3 ((Suppl)) 7-13
- 17 Janszky J, Fogarasi A, Jokeit H, Ebner A. Are ictal vocalization related to the lateralisation of frontal lobe epilepsy?. J Neurol Neurosurg Psychiatry. 2000; 69 244-247
- 18 Kellinghaus C, Luders HO. Frontal lobe epilepsy. Epileptic Disord. 2004; 6 223-239
- 19 Laskowitz DT, Sperling MR, French JA, O’Connor MJ. The syndrome of frontal lobe epilepsy: characteristics and surgical management. Neurology. 1995; 45 780-787
- 20 Luders H, Acharya J, Baumgartner C, Benbadis S, Bleasel A, Burgess R. et al . Semiological seizure classification. Epilepsia. 1998; 39 1006-1013
- 21 Manford M, Fish DR, Shorvon SD. An analysis of clinical seizure patients and their localizing value in frontal and temporal lobe epilepsy. Brain. 1996; 119 17-40
- 22 Morris 3rd HH, Dinner DS, Luders H, Wyllie E, Kramer R. Supplementary motor seizures: clinical and electrographic findings. Neurology. 1988; 38 75-82
- 23 Pachaz C, Fusco L, Vigevano F. Epileptic spasms and partial seizures as a single ictal event. Epilepsia. 2003; 44 693-700
- 24 Rasmussen T. Characteristics of a pure culture of frontal lobe epilepsy. Epilepsia. 1983; 24 482-493
- 25 Sartori E, Biraben A, Taussig D, Bernard AM, Scarabin JM. Gelastic seizures: video-EEG and scintigraphic analysis of a case with a frontal focus; review of the literature and pathophysiological hypotheses. Epileptic Disord. 1999; 1 221-228
- 26 Saygi S, Katz A, Marks DA. et al . Frontal lobe partial seizures and psychogenic seizures: comparison of clinical and ictal characteristics. Neurology. 1992; 42 1274-1277
- 27 Scheffer IE, Bhatia KP, Lopes-Candes I. et al . Autosomal dominant frontal lobe epilepsy misdiagnosed as sleep disorder. Lancet. 1996; 147 515-517
- 28 Sinclair B, Wheatley M, Snyder T. Frontal lobe epilepsy in childhood. Pediatr Neurol. 2004; 30 169-176
- 29 Swartz BE, Halgren E, Delgado-Escueta AV. et al . Neuroimaging in patients with seizures of probable frontal origin. Epilepsia. 1989; 30 547-558
- 30 Vigevano F, Fusco L. Hypnic tonic postural seizures in healthy children provide evidence for a partial epileptic syndrome of frontal lobe origin. Epilepsia. 1993; 34 110-119
- 31 Wyllie F. Surgery for catastrophic localization-related epilepsy in infants. Epilepsia. 1996; 37 ((suppl. 1)) 22-25
Correspondence
F. Guzzetta
Francesco Guzzetta
Catholic University
Child Neurology
Largo Gemelli 8
00168 Rome
Italy
Email: fguzzetta@rm.unicatt.it