Ictal Seizures Captured With Video-electroencephalogram In Infants With Epilepsy

Objective:To investigate the seizure types in infants.Methods:We analyzed all the attacks in children under the age of two years at Shenzhen children’s hospital during seven years captured with VEEG,which was with suspicion of epilepsy.Results:The seizure types were as follows (1) generalized seizures including41cases:①tonic-clonic seizures in4cases,attack duration59.75±58.93s,Median(M)=38.5s,tonic seizures lasted17.25±15.81s,M=12.5s,clonic seizures lasted35±29.54s,M=29s,the ictal EEG showed all the brain waves inhibited or low fast rhythm transferred into spike and slow waves;②myoclonic seizures in31cases,the ictal EEG showed poly-spike and slow waves with attack duration186.67±29.16milliseconds,M=200ms;③tonic seizures in6cases.the ictal EEG showed low fast rhythm and attack duration36.66±16.97s,M=34s.(2)epileptic spasms in302cases,with younger than1year old219patients,1-2years old83patients.attack duration1.35±0.67s,M=1s,which showed hypsarrhythmia in interictal EEG,including210patients with hypsarrhythmia variants,the ictal EEG was high amplitude single slow wave and/or low fast rhythm.Clinical manifestation of flexor muscle type in216cases,extensor muscle type29cases,mixed22cases.Eye movement.slight shaking were not typical attack in35cases.(3)partial seizures in232cases, attack duration115.32±156.72s,M=70s,the prominent manifestations were stiffness jitter and less or no movement with staring.Other seizure types included simple automatisms and mild convulsive seizures.The origins of partial seizures were from frontal in13cases, central20cases,temporal46cases or occipital areas13cases,including multiple area of origin in17cases.(4)epilepticus status in10cases,attack duration lasted for30minutes or longer.(5) complex seizures in43cases,VEEG showed one type transferred into another type in one attack.(6) the non-epileptic attacks in372cases,attack occurred during awake in214cases,in sleep111cases,in both sleep and awake werein47cases,attack duration lasted1～10seconds,the prominent manifestations were slight shaking,the whole body rigid for about one second,EEG showed movement artifact or no background changes. Conclusion:VEEG monitoring is helpful to the classification of seizures in infants with suspicion of epilepsy.Epileptic spasms and partial seizures are main seizure types in infants younger than two years old. They must be differentiated from non-epileptic attacks which is also common.