Adult New Onset Gelastic Seizures of Cortical Origin.
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ABSTRACT:
SUBMITTER: Costa A
PROVIDER: S-EPMC7191665 | biostudies-literature | 2020 Apr
REPOSITORIES: biostudies-literature
Publications
Adult New Onset Gelastic Seizures of Cortical Origin.
Costa Alexandre A Supermanian Sharwend S Matar Mazen M Scott James J
The Neurohospitalist 20191104 2
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Project description:ObjectiveTo investigate the presenting characteristics of new-onset afebrile seizures in infants (age 1-24 months) and the yield of neuroimaging.MethodsProspective data were obtained from a standardized evaluation and management plan mandated by a critical care pathway. A total of 317 infants presented with new-onset afebrile seizures between 2001 and 2007. EEG was performed on 90.3%, head CT was obtained on 94%, and MRI was obtained on 57.4%.ResultsWe found half of the infants had partial features to their seizures, yet evidence for primary generalized seizures was rare. The majority had more than 1 seizure upon presentation. Seizures in this age group tended to be brief, with 44% lasting less than 1 minute. EEG abnormalities were found in half. One-third of CTs were abnormal, with 9% of all CTs requiring acute medical management. Over half of MRIs were abnormal, with cerebral dysgenesis being the most common abnormality (p < 0.05). One-third of normal CTs had a subsequent abnormal MRI-only 1 resulted in altered medical management.ConclusionsInfantile seizures are usually brief, but commonly recurrent, and strong consideration should be made for inpatient observation. Acute imaging with CT can alter management in a small but important number of infants. Due to the superior yield, strong consideration for MRI should be given for all infants, as primary generalized seizures are rare, and there is a high rate of cerebral dysgenesis.
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