Long term prognosis of symptomatic occipital lobe epilepsy secondary to neonatal hypoglycemia

Montassir, Hesham; Maegaki, Yoshihiro; Ohno, Kousaku; Ogura, Kaeko

doi:10.1016/j.eplepsyres.2009.10.001

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Volume 88, Issue 2 , Pages 93-99, February 2010

Long term prognosis of symptomatic occipital lobe epilepsy secondary to neonatal hypoglycemia

Hesham Montassir
- Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
- Corresponding author. Tel.: +81 859 38 6777; fax: +81 859 38 6779.
Yoshihiro Maegaki
- Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
Kousaku Ohno
- Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
Kaeko Ogura
- Information Center for Persons with Developmental Disabilities, Research Institute, National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa, Saitama, 359-8555, Japan

Received 13 March 2009; received in revised form 13 July 2009; accepted 4 October 2009.

Summary

Purpose

To report on long-term clinical course in patients with symptomatic occipital lobe epilepsy secondary to neonatal hypoglycemia.

Methods

Six patients with neonatal hypoglycemia and symptomatic occipital lobe epilepsy were studied in our hospital through reviewing their medical records retrospectively.

Results

The median onset age of epilepsy was 2 years 8 months and median follow-up period was 12 years and 4 months. Initial seizure types were generalized convulsions in 4 patients, hemiconvulsion in 1, and infantile spasms in 1. Ictal manifestations of main seizures were identical to occipital lobe seizures, such as eye deviation, eye blinking, ictal vomiting, and visual hallucination. Seizure frequency was maximum during infancy and early childhood and decreased thereafter with no seizure in 2 patients, a few seizures a year in 3, and once a month in 1. All patients had status epilepticus in the early course of epilepsy. EEGs showed parieto-occipital spikes in all patients. MRI revealed cortical atrophy and T2 prolongation parieto-occipitally in 4 patients, hippocampal atrophy in 1, and unremarkable in 1.

Conclusion

This study indicates that epilepsy secondary to neonatal hypoglycemia is intractable during infancy and early childhood with frequent status epilepticus but tends to decrease in older age.

Keywords: Occipital lobe epilepsy, Neonatal hypoglycemia, Status epilepticus, MRI, Prognosis