Trastorno de conducta en el niño: en ocasiones se esconde algo más

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Abstract

Resumen La epilepsia focal del lóbulo temporal se presenta en la edad pediátrica con manifestaciones clínicas heterogéneas, incluyéndose entre ellas las alteraciones sensoperceptivas y los trastornos de la conducta, pudiendo llegar a ser manejados inicialmente como pacientes psiquiátricos, lo que retrasa el diagnóstico y el inicio del tratamiento.

Translated abstract

Abstract Temporal lobe epilepsy in childhood may present with a wide spectrum of symptoms, including behavioral changes and sensory symptoms. This situation can seem like a psychiatric pathology and can delay the diagnosis and initiation of treatment.

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Most cited references 5

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Familial temporal lobe epilepsy: a clinically heterogeneous syndrome.

E Andermann, I. Lopes-Cendes, F. Andermann … (1998)

We describe the clinical characteristics of a group of patients with familial temporal lobe epilepsy (TLE) in 11 kindreds with 36 affected individuals identified and investigated at the Montreal Neurological Hospital. Seizure types were simple partial (n = 20), complex partial (n = 29), and rare generalized tonic-clonic. Simple and complex partial seizures were infrequent or well controlled by anticonvulsant medication in 17 of 29 patients (59%) and without optimal response to medical therapy in 12 of 29 patients (41%). Pedigree analysis suggested autosomal dominant inheritance with incomplete penetrance. The syndrome of familial TLE has heterogeneous clinical manifestations and is not always benign.

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Temporal lobe epilepsy in childhood: clinical, EEG, and neuroimaging findings and syndrome classification in a cohort with new-onset seizures.

John Hopkins, Steven Harvey, J Wrennall … (1997)

Sixty-three children with new-onset temporal lobe epilepsy (TLE) underwent extensive clinical, EEG, and neuroimaging investigation as part of a prospective, community-based cohort study of the natural history of TLE in childhood. Complex partial seizures occurred in 94% of the children, and tonic-clonic seizures occurred in 14%. Developmental, behavioral, or learning problems were present in 38%. Eighteen children (29%) had a significant illness/event prior to the onset of TLE, including febrile status epilepticus in seven, meningitis in four, respiratory arrest in two, and head injury in one. Magnetic resonance imaging or computed tomography revealed structural abnormalities of the temporal lobe in 24 children (38%), including hippocampal sclerosis (HS) in 13 and tumor in eight. There was a strong association between HS and a history of significant illness/event prior to the onset of TLE (p < 0.001). Analysis of past history and neuroimaging findings led us to propose three etiologically defined subgroups of TLE; developmental TLE (10 children with long-standing, nonprogressive temporal lobe tumors and malformations), TLE with HS/significant antecedents (18 children with HS or a history of a significant illness/event), and cryptogenic TLE (34 children with normal neuroimaging findings and no significant past history). Etiologic differences between children with new-onset TLE may confer prognostic information that will be useful for counselling families and planning treatment.

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Age-dependent seizure semiology in temporal lobe epilepsy.

Ingrid Tuxhorn, Anna Kelemen, András Fogarasi … (2007)

To examine the effects of age on different aspects of temporal lobe seizure semiology. We performed a video analysis of 605 archived seizures from 155 consecutive patients (age 10 months to 49 years) selected by seizure freedom after temporal lobectomy. Eighty patients had hippocampal sclerosis (HS). Beside semiological seizure classification, we assessed age dependency of several axes of seizure semiology: (1) aura, (2) number of different lateralizing signs, occurrence of ictal (3) emotional signs, (4) autonomic symptoms, (5) automatisms, and (6) secondary generalization as well as (7) the ratio of motor seizure components. From the 155 patients, 117 reported aura, 39 had ictal emotional signs, 51 had autonomic symptoms, 130 presented automatisms, while 18 patients showed secondary generalization at least once during their seizures. Altogether 369 (median: 2/patient) different lateralizing signs were recorded. Frequency of HS (p < 0.001), ictal automatisms (p < 0.001), secondary generalization (p = 0.014), number of different lateralizing signs (p < 0.001) increased while the ratio of motor seizure component (p = 0.007) decreased by age. Auras, emotional symptoms, and autonomic signs occurred independently of patients' ages. Hippocampal sclerosis adjusted linear models revealed that the frequency of automatisms and secondarily generalized seizures as well as the number of different lateralizing signs are HS-independent significant variables. Our findings support that brain maturation significantly influences the evolution of some important aspects (motor seizures, lateralizing signs) of temporal lobe seizure semiology. Conversely, other aspects (aura, emotional, and autonomic signs) are independent of the maturation process. This is the first report investigating age dependency of epileptic seizure semiology comparing all age groups.

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Journal

Journal ID (publisher-id): pap

Title: Pediatría Atención Primaria

Abbreviated Title: Rev Pediatr Aten Primaria

Publisher: Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )

ISSN (Print): 1139-7632

Publication date (Print and electronic): March 2020

Volume: 22

Issue: 85

Pages: 35-37

Affiliations

[2] Valladolid orgnameHospital Clínico Universitario orgdiv1Servicio de Pediatría España

[1] Valladolid orgnameHospital Clínico Universitario España

Article

Publisher ID: S1139-76322020000100006 Publisher ID: S1139-7632(20)02208500006

SO-VID: 2479bdd0-6d5b-42af-92f9-84c3f1fbf720

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Trastorno de conducta en el niño: en ocasiones se esconde algo más Translated title: Conduct disorder in child, sometimes something may be hidden

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Most cited references 5

Familial temporal lobe epilepsy: a clinically heterogeneous syndrome.

Temporal lobe epilepsy in childhood: clinical, EEG, and neuroimaging findings and syndrome classification in a cohort with new-onset seizures.

Age-dependent seizure semiology in temporal lobe epilepsy.

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