Evaluation of Childhood Epilepsies with Frontal Paroxysm

Objective: To compare the clinical and laboratory findings of pediatric patients with the diagnosis of epilepsy whose interictal electroencephalogram had frontal epileptiform activity and to determine their semiological classification. Method: The patients were divided into two groups according to the etiology. Patients with genetic-idiopathic etiology were defined as primary, structural, metabolic, or symptomatic cases without a cause were defined as secondary group. Luders classification was used for seizure semiology. Results: The study consisted of 91 patients between 1days-18 years of age (10.7 ± 4.2 years). Forty-two patients (46.2%) constituted primary group and 49 patients (53.8%) constituted secondary group. Newborns and infants aged 0-24 months constituted the majority (45.2%) of the seizure onset age. Seizure types which is specific to frontal lobe epilepsy (FLE) were found in 49 patients (53.8%). The most frequent seizure type was clonic seizure observed in 19 patients (20.9%). Seizure types not specific to FLE were detected in 42 (46.2%) patients. The most frequent seizure type in this group was tonic-clonic seizure observed in 23 patients (25.3%). The most common pathologic finding was sequelae lesions in cranial imaging (71.3%). Epilepsy control could not be achieved in 40.6% of patients with antiepileptic drug therapy. Conclusion: In primary group, later age at onset of seizures and better response to treatment can be expected. In childhood FLE, seizure types that are not specific for frontal lobe epilepsy are seen as frequently as seizures specific to FLE. It is difficult to control epilepsy with antiepileptic drug therapy in patients with FLE.
Keywords: Seizures, semiology, frontal epilepsy, epilepsy, child