Frontal lobe epilepsies in childhood. Is there a benign partial frontal lobe epilepsy?

Introduction. Only the organic and cryptogenic forms of frontal lobe epilepsy have beer? admitted by the ILAE, but according to several reports in the literature, it probably exists also an idiopathic form, at present not well recognized Objective. To study the differences between the organic and the cryptogenic forms of frontal epilepsy in our patients, that might indicate the presence of idiopathic cases within the presumed cryptogenic group. Material and methods, All patients diagnosed of frontal lobe epilepsy, EEG registered at the neuropediatric clinic of our hospital during 1993-1996 were selected: 30 patients under 14 years of age that were classified as organic (10 cases) or cryptogenic (20 cases) according to CT or MRI findings. The Mann-Whitney test and the Fisher exact rest were performed for statistical analysis. Five patients with peculiar neurocognitive symptoms, epilepsy-related are described in detail. Results. Significative differences between the organic and cryptogenic forms of frontal lobe epilepsy were not found except for the tendency of cryptogenic EEG foci to spread beyond the frontal lobe, to generalize and to be associated with foci of other localizations. Epileptic status, either convulsive or not convulsive, were a frequent complication in both groups. Conclusions. The identification of an idiopathic form of frontal lobe epilepsy is difficulted by its low prevalence as compared to the cryptogenic and organic forms, by the tendency of frontal seizures to become epileptic status, which predicts an intractable epilepsy, and by the clinical characteristics essential to frontal discharges, heterogeneity,frequent impairment of conciousness and specially the the neurocognitive semiology, including dementia, that occurs as a critic or paracritic phenomenon, and that sometimes may develop or be accentuated by antiepileptic medication [REY NEUROL 1998, 26: 919-23].