摘要
Generally, symptomatic and idiopathic forms of partial epilepsies in childhood are characterised by very different electroclinical features; yet it happens that in some cases a symptomatic form having some electroclinical findings mimiking an idiopathic form can cause a diagnostic mistake. In order to help a correct diagnosis we present the results of an electroclinical and neuroradiological study of 10 children suffering from a symptomatic partial epilepsy mimiking an idiopathic form. They are 6 males and 4 females, without significant personal antecedents and neurological deficits, suffering from a partial epilepsy that appeared at the mean age of 5 yrs 8 mths. All cases were followed longitudinally at our Service with repeated EEG polygraphic recordings during wake and sleep, and their actual mean age is 10 yrs 6 months. The seizures have been well controlled by treatment in 4 cases, while they are more or less pharmacoresistant in 5 cases. The neuroradiological investigation showed unilateral focal gyral anomalies in all cases (schizencephaly 3, focal cortical dysplasia 6 and micropolygyria 1). The clinical characteristics that mainly showed up as suggesting a symptomatic nature were an ictal symptomatology evoking an initial involvement of a cerebral area other than rolandic and a frequent observation of slight local motor deficit that often fluctuated into a severe deficit according to seizure recurrence rate; the electrical characteristics were a peculiar rhythmicity of the interictal abnormalities both during wake and sleep, a morphological modification during sleep, the presence of an unusual theta activity increasing particularly at wake-up and the frequent observation of unusual EEG activity both during wake and sleep.