Evaluation of Source Generators in Partial Seizures : Availability of Neuroradiological Images Superimposed on the Dipole Tracing

To clarify the anatomical localization of epileptic foci in childhood partial seizures, the source generators of interictal focal spikes were analyzed using a dipole tracing method and the effectiveness of a composite image diagnostic technique using neuroradiological images obtained by magnetic resonance imaging and single photon emission computed tomography was evaluated. The localization of electric source generators approximately reflects the abnormal lesions on neuroradiological images. However, the source generators tended to be located in the deep and/or peripheral parts of the abnormal regions. Even though systemic shifts in the position of optimal dipoles from their true positions is a limitation that must be taken into consideration, composite image diagnostic technique may be useful for evaluating the epileptogenic regions in partial seizures, and particularly, in children where noninvasive methods are preferable

Complex Partial Seizures Evolving into Periodic Spasms

A case of complex partial seizures evolving into periodic spasms is described. A six-month-old boy was referred to us because of complex partial seizures characterized by impairment of consciousness followed by adversion of the eyes and face associated with asymmetric tonic neck reflex-like postures. Interictal electroencephalography (EEG) on admission revealed multiple independent spike foci and clusters of the fast activities, which tended to be pseudoperiodic, during sleep. Ictal EEG showed irregular high voltage slow waves in the left hemisphere which gradually developed into diffuse slow waves followed by periodic sharp and/or slow waves associated with periodic spasms every two or five seconds. He had mild hemiparesis in the right upper limb. Otherwise his development of gross movement was normal. His seizures occurred frequently during the waking state, but sodium valproate was effective. In West syndrome, it is well known that epileptic seizures are characterized by a series of spasms. However, few patients with partial seizures in infancy have been reported to have periodic spasms