Abstract
The patient was a 12-month-old male infant who experienced the first seizure at 27 days of age. He was born at full term and he had no abnormality at birth. Seizures developed from twitches of the left or right eyelid to tonic jerks of one or both upper limbs. Ictal EEG showed spikes started in the right or left occipital region and spread out to the entire cerebrum, and spikes moved to the frontal region. Ictal ECD-SPECT showed hyperperfusion in the occipital region. Conventional antiepileptic drugs failed to control the seizures. His development arrested and he showed spastic quadriplegia and severe mental retardation. His brain MRI was normal and there was no cortical dysplasia. He was diagnosed as having occipital lobe epilepsy; however, his seizure types, other symptoms and ictal EEG resemble to the malignant migrating partial seizures in infancy. Intractable partial seizures and migrating epileptic focus may depend on the brain immaturity in infancy.
