Value of Focality in Epileptic Spasm

One of the most common epilepsies in infancy are epileptic spasms. Diagnosis and early treatment is very important. There is a syndromic epilepsy that early diagnosis and treatment result in a better neurological outcome. Epileptic spasm could not evolved into LGS by Early diagnosis and treatment. Epileptic spasm with focality is one of the things that delays our diagnosis and makes the Disease resistant to the treatment, that patients may benefit from e-surgery. According to the new classification of 2017, Epileptic spasm has been reported in all three types of focal, generalized, and unknown onset epilepsy. In cases of refractory treatment and cases that show bad or malignant syndrome and devastating epilepsy, or in developmental regression, Epileptic spasm is seen with a focality that is treated with e-surgery and resection of the focal lesion. These focalities may first be obtained by evaluating the initial ictal semiology. Which shows focal signs or focal seizures as a motor or nonmotor , and we find focality in the pre -ictal semiologic evidence , for example, head version, unilateral eye blinking, …. So, asymmetric or unilateral spasm, and even Epileptic spasms in clusters suggest focality.It may be possible to see the focality in electroencephalography, based on ictal or interictal EEG.Interictal hemi-hypsarrhythmia, asymmetric hypsarrhythmias and unilateral hypsarrhythmias express the existence of focality too . And finally, we can find out focality by MRI . Twenty patients, who suffered epileptic spasm and were monitored in LTME in our hospital. 40% of patients had abnormal findings in MRI. Based on EEG, 70% of cases were found with focality.

کلیدواژه ها:

Epileptic spasm ، Hypsarrhythmia ، focallity