1988 Volume 6 Issue 1 Pages 85-97
A detailed electroclinical analysis was carried out in 15 patients with nocturnal Sylvian seizures followed by a series of minor motor seizures (MMS). The mean age of onset of Sylvian seizures were 4 years and 9 months old and that of MMS were 6 years and 4 months old.
Simultaneous video-EEG recordings or polygraphic recordings carried out in the 6 cases demonstrated the fact that regional rolandic sharp and slow wave complexesand diffusely propagated discharges were coincident with atonic drops of a contralateral upper limb and head nodding of atypical absence, respectively.
Correlation between the onset of the MMS and the initiation of CBZ, which recently stressed by some reports, revealed negative results. With frequent seizures, continuous sharp and slow wave complex were present during sleep. Family history of the epilepsy was found in 5/15 patients.
Some cases were initially medically difficult to manage, but 11 cases, in which longterm follow-up was possible, showed eventual remission of clinical seizures at theage of 8-10 years.
A unique pattern of clinical ictal sequencing and the chronological evolution observed in our series suggest that they should be regarded as an intermediate type between benign partial and secondary generalized epilepsies.
We should also pay attention to the neurophysiological significance of the high voltage sharp and slow wave complexes on the Rolandic area and their diffuse propagation, which would correspond with the partial inhibitory seizures and brief atonic absences, respectively.
