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Self-Limited Epilepsy with Autonomic Seizures (SeLEAS): A Case series

Objective Self-Limited Epilepsy with Autonomic Seizures (SeLEAS), previously known by the eponymous Panayiotopoulos syndrome, is a benign focal epilepsy of the pediatric age group. It is characterised by nocturnal seizures with dominant autonomic features. Limited data from India exists on SeLEAS. We aimed to describe the clinical, demographic and treatment-related features of SeLEAS, previously considered as benign, can still have long term implications.

Methods In this descriptive retrospective cohort study, we reviewed record of children from May 2017- October 2018 who met criteria for SeLEAS. Each patient’s clinical, demographic, electroencephalographic, neuroimaging and treatment details were reviewed. Response to anti-seizure medications was also recorded.

Results Twenty three children with SeLEAS were enrolled (males=18; 78.2%). Median age at onset was 4 (interquartile range 2.5-10) years and median age at presentation was 6 (2.5-11) years. Focal seizures were observed in 65.2% (n=15) and 30% (n=7) had history of status epilepticus. Ictal/postictal emesis was observed in all patients. Occipital spikes on electroencephalography were seen in 78% (n=17). two children progressed to CSWS (Continuous Spike Wave in Sleep). Four children had poor scholastic performance. Most (70%) of patients were well controlled on monotherapy, even with older antiseizure medications.

Conclusions This cohort shows the spectrum of clinical heterogeneity associated with SeLEAS. Although considered benign, occurrence of status epilepticus and poor scholastic performance among some of our patients, suggests that some caution may be appropriate while prognosticating such patients. These seizures cab be well controlled with monotherapy.
Keywords: Self Limiting Epilepsy, Autonomic