Complex Partial Seizures in Young Children

Summary: We retrospectively analyzed the clinical manifestations of complex partial seizures (CPS) in children aged 10 years using video and EEG telemetry and evaluated their course, investigations, management, and seizure status at follow-up. Seventeen patients with CPS were studied at the Prince of Wales Children's Hospital (POWCH) and Prince Henry Hospital (PHH) between 1987 and 1992. Because 1.5 of the 17 patients had intractable seizures, the population was selective. Mean age was 6.5 years; 4 patients were aged 2 years. Clinical features were normal or mild intellectual handicap (1 3); hemiplegia (5); and infantile spasms preceding CPS (4); of these, 2 also had simple partial motor seizures. Structural abnormalities were noted on scanning in 9 patients. Eighty-seven seizures were reviewed. Mean duration of each clinical seizure was 59.7 s (total population), 108 s (subgroup 1, aged 2 > years), and 48.5 s (subgroup 2, aged 2 years). Major ictal manifestations were auras (9), staring (9), autonomic changes (6), and automatisms (17). In subgroup 1, automatisms were simple and mainly oroalimentary and gestural. Two patients had no change in surface ictal recordings, and 2 had normal interictal EEGs. At follow-up, 8 patients were seizure-free for 6 months, 1 was partially controlled (more than two seizures a month), and 8 had intractable seizures (two or more seizures a month). Seven patients underwent operation for intractable epilepsy, and 4 achieved a class 1A outcome (Engel classification).