Abstract
Objective
To analyze the electroclinical features and evolution of seven infants with benign infantile focal epilepsy with midline spikes and waves during sleep (BIMSE).
Material and methods
Seven patients were examined at our department between February 2003 and February 2009, with onset of seizures between six and 13 months of age (mean, 10.2 months; median, 11 months). Patients with cryptogenic and symptomatic focal epilepsies were excluded. Sex, age, familial history, type of seizures and AED treatment were noted and EEG monitoring, MRI and CT scanning, and developmental and psychomotor evolution were investigated.
Results
Patients included five males and two females. All patients suffered from seizures during wakefulness. Two of the patients (29%) did not have a recurrence. Five (71%) had sporadic seizures (ranging between two and five). One of the seven patients (14%) presented with seizures in clusters. During seizures, staring was observed in six (86%), motion arrest in five (71%), stiffening in five (71%), cyanosis in three (42%), automatisms in one (14%) and lateralizing signs in four (57%). Two patients (29%) had secondary generalisation. The duration of the seizures ranged between 30 seconds and five minutes. No status epilepticus was observed. The interictal EEG recording during sleep showed low-voltage unilateral or bilateral spikes located in the central and vertex regions, followed by slow waves in all patients. Outcome was excellent in all patients.
Conclusion
We believe that BIMSE is a new syndrome rather than an early presentation of benign epilepsy of childhood with centrotemporal spikes, Panayiotopoulos syndrome, or a late presentation of benign focal infantile seizures.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Bureau M, Cokar O, Maton B, Genton P, Dravet C. Sleep-related, low voltage Rolandic and vertex spikes: an EEG marker of benignity in infancy-onset focal epilepsies. Epileptic Disord 2002; 4: 15–22.
Bureau M, Maton B. Valeur de l’EEG dans le pronostic précoce des épilepsies partielles non idiopathiques de l’enfant. In: Bureau M, Kahane P, Munari C, eds. Epilepsies partialles graves pharmaco-resistantes de l’enfant: stratégies diagnostiques et traitements chirugicaux. London: John Libbey, 1998: 67–78.
Capovilla G, Beccaria F. Benign partial epilepsy in infancy and early childhood with vertex spikes and waves during sleep: a new epileptic form. Brain Dev 2000; 22: 93–99.
Capovilla G, Beccaria F, Montagnini A. Benign focal epilepsy in infancy with vertex spikes and waves during sleep. Delineation of the syndrome and recalling as benign infantile focal epilepsy with midline spikes and waves during sleep. Brain Dev 2006; 28: 85–91.
Capovilla G, Beccaria F. Benign Infantile focal epilepsy with midline spikes and waves during sleep. In: Caraballo R, Fejerman N, eds. Benign Focal Epilepsy in Infancy, Chilhood and Adolescence. Paris: John Libbey Eurotext, 2007: 63.
Caraballo R, Cersósimo R, Galicchio S, Fejerman N. Convulsiones Familiares Benignas de la Infancia. Rev Neurol (Barc) 1997; 25: 682–684.
Caraballo R, Cersosimo RO, Espeche A, Fejerman N. Benign familial and non-familial infantile seizures: a study of 64 patients. Epileptic Disord 2003; 5: 45–49.
Dalla Bernardina B. Sgro’ V, Fejerman N. Epilepsy with centrotemporal spikes and related syndromes. In: Roger J, Bureau M, Dravet C, Genton P, Tassinari CA, Wolf P, eds. Epileptic syndromes in infancy, childhood and adolescence. London: John Libbey, 2002: 181–202.
Engel J. Epilepsy a comprehensive textbook. Lippincott Williams & Wilkins, 2008: 2316–2321
Fukuyama Y. Borderland of epilepsy with special reference to febrile convulsions and so-called infantile convulsions. Seishing-Igaku. Clin Psychiatry 1963; 5: 211–223.
Vigevano F, Fusco L, Di Capua M, Ricci S, Sebastianelli R, Lucchini P. Benign infantile familial convulsions. Eur J Pediatr 1992; 151: 608–612.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Flesler, S., Sakr, D., Cersósimo, R. et al. Benign infantile focal epilepsy with midline spikes and waves during sleep: a new epileptic syndrome or a variant of benign focal epilepsy?. Epileptic Disord 12, 205–211 (2010). https://doi.org/10.1684/epd.2010.0320
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1684/epd.2010.0320