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Clinically silent seizures in a neonate with tuberous sclerosis
Author(s) -
Ikeno Mitsuru,
Okumura Akihisa,
Abe Shinpei,
Igarashi Ayuko,
Hisata Ken,
Shoji Hiromichi,
Shimizu Toshiaki
Publication year - 2016
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12738
Subject(s) - tuberous sclerosis , medicine , electroencephalography , ictal , epilepsy , epileptic spasms , magnetic resonance imaging , pediatrics , subependymal zone , psychomotor learning , pathology , radiology , psychiatry , cognition
Although seizures during infancy in patients with tuberous sclerosis complex are common, seizures in neonates are infrequent. Here, we report the clinical course and electroencephalography (EEG) findings of a neonate with tuberous sclerosis complex associated with clinically silent seizures. The patient was a girl in whom cardiac tumors were detected on fetal ultrasonography. Brain magnetic resonance imaging during the neonatal period showed subependymal and cortical tubers. Routine EEG indicated unexpected ictal changes with no noticeable clinical symptoms. Ictal EEG was associated with a subtle increase in heart rate and a brief increase in chin electromyogram. These changes were difficult to identify clinically. The patient later developed focal seizures and epileptic spasms and had severe psychomotor delay. The present case suggests the occurrence of clinically silent seizures before the appearance of epileptic spasms in infants with tuberous sclerosis, and that EEG is an option for neonates with a prenatal diagnosis.