Special epilepsy syndrome of lesional origin

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Special epilepsy syndrome of lesional origin

• Gelastic seizures (giggling attacks)
• lt 2 years of age
• Hamartoma of hypothalamus
• Frequent seizures
• Difficult to treat
• Precocious puberty is frequent
• Surgical excision when possible

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3-Epilepsies and syndromes undetermined whether
focal or generalised

• 1-With both generalised and focal seizures
• Neonatal seizures
• Severe myoclonic epilepsy in infancy
• Epilepsy with continuous spike-waves during slow
  wave sleep
• Acquired epileptic aphasia (Landau-Kleffner
  syndrome)
• Other undetermined epilepsies not defined above
• 2- Without unequivocal generalised or focal
  seizures

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Severe myoclonic epilepsy in infancy

• Onest 4-10 months of age
• Unilateral prolonged clonic seizures precipitated
  by fever in 75
• Partial seizures, myoclonic, atypical absence and
  nonconvulsive status develop at the age 2-3 years
• Slowing of mental development
• EEG Burst of fast spike-wave complex with
  multifocal spikes
• 25 associated with photosensitivity
• Out come is poor
• VAL,LMT,TOP,Levatricetam, Clobazam

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Acquired epileptic aphasia (Landau-Kleffner
syndrome)

• Receptive aphasia with paroxysmal sleep EEG
  activity
• Awake EEG will show spike on temporal lobe
• Onest 2-6 years of age
• 80 will have convulsive seizures (generalised
  and partial)
• Unknown cause
• MRI and PET usually normal
• MagenticEEG Spikes originated from left auditary
  area
• AED failed to control it
• Steroids
• Multiple temporal resection
• Seizures will stop by age 15years but language
  problems will persist even in adulthood

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4-Special syndromes

• 1-Situation-related seizures
• febrile convulsion
• Seizures occurring only in the context of acute
  metabolic or toxic events
• 2- Isolated seizures or isolated status
  epilepticus

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