Abstract
In childhood partial epilepsies, intcrictal focal seizure discharges present in the waking EEG occasionally show a significant increase throughout all stages of sleep. The spikes may spread during slow wave sleep to the adjacent regions, and, in some cases, may display significant bilateral diffusion. We studied EEG changes, evolution of seizures, changes of mental functions, and prognosis in 25 patients whose EEGs demonstrated such generalization similar to the continuous spike-wave sleep (CSWS) syndrome. The ages of patients at follow-up ranged from 8 to 19 years. Patients were divided into 3 groups as follows; group 1: 11 patients with only EEG generalization, group 2: 10 patients with non-convulsive generalized seizures, and group 3: 4 patients with significant psychomotor deterioration.
The results were as follows;(1) group 1 patients were the oldest at the time of generalization of focal seizure discharges and showed spike-wave indexes of less than 85% in non-REM sleep, (2) group 2 patients with non-convulsive generalized seizures had more focal motor seizures and speech problems with localization of focal seizure discharges on central areas, (3) all group 3 patients with psychomotor deteriorations showed spike-wave indexes of more than 85% in non-REM sleep, (4) when EEGs were normalized, prognosis was relatively good.
We considered that a variety of symptoms during a period of a generalization of focal seizure discharges was related to a localization of focal seizure discharges and a continuity of generalized spike-waves. And we should pay attention to mild psychic symptoms, such as, personality changes or abnormal behaviors during the period of generalization of focal seizure discharges even if spike-wave indexes in non-REM sleep were less than 85%.
