Epilepsy associated with infantile hemiplegia in adult: Clinical characteristics and results of surgery.
- Author:
Joo Yong KIM
1
;
Sang Kun LEE
Author Information
1. Department of Neurology , College of Medicine, Seoul National University.
- Publication Type:Original Article
- Keywords:
Epilepsy;
Infantile hemiplegia;
Hemiplegia;
Surgery
- MeSH:
Adult*;
Age of Onset;
Child;
Electroencephalography;
Epilepsy*;
Epilepsy, Temporal Lobe;
Hemiplegia*;
Hemispherectomy;
Humans;
Magnetic Resonance Imaging;
Seizures;
Tomography, Emission-Computed, Single-Photon
- From:Journal of the Korean Neurological Association
1998;16(6):826-838
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Many children with acute infanti]e hemiplegia (AIH) develop epilepsy later. Epilepsy associated with AIH has been generally thought to be medical]y intractable and difficult to be treated surgically. We report 15 patients with intractable epilepsy associated with AIH, 10 of whom received surgery. METHODS: All patients underwent comprehensive presurgical evaluation, including video-EEG monitoring, MRI, PET, interictal and ictal SPECT. RESULTS:The onset of AIH was at mean age of 19 months, accompanied by hyperpyrexia and repeated convulsion. Subsequent epilepsy started at mean age of 11 years, which could be subdivided by mesial temporal lobe epilepsy (MTLE) in 8 patients (53%) and neocortical or multifocal epilepsy in 7 patients (47%). The mean age of onset of AIH was earlier in MTLE group and the mean age of onset of subsequent epilepsy was earlier in neocortlcal group, although not significant statistically. The patients demonstrated variable spectrums of abnormalities on EEG, MRI, PET, and SPECT, but neocortica] group tended to show more widespread abnormalities than MTLE group. Surgery was performed in 7 of 8 in MTLE group and 3 of 7 in neocortica] group, and the outcome was excellent in MTLE group. CONCLUSION: Epilepsy associated with AIH showed two distinct subtypes; MTLE and neocortical/multifoca] epilepsy. Because the surgical outcome in selected cases with well-localized epileptogenic zone was excellent, careful clinical consideration and presurgical evaluation will be needed for management planning and to avoid unnecessary hemispherectomy.
