Convulsive Disorders in the First Year of Life: Etiologic Factors

Among 746 patients with first year convul‐ sions, 140 had febrile convulsions (36% with a positive family history of convulsive disorders) and 169 had epileptic seizures due to acute brain injuries (10% with a positive family history). No brain malformation was detected in these cases. The 437 remaining patients (21% with a positive family history) included only those with chronic afebrile seizures not due to acute postnatal injuries (173 cryptogenic and 264 symptomatic). Brain malformations were found in 82 cases. The incidence of a family history was highest (40%) in cryptogenic cases not expressed as status epilepticus or infantile spasms, and was inversely related to that of brain lesions. An age below 6 months at the first seizure was linked with brain lesions, with infantile spasms or status epilepticus. Females were more apt to develop cryptogenic status epilepticus. Brain malformations were significantly associated with infantile spasms. The role of pre‐ and perinatal antecedents is not as exclusive as previously thought. Among the other factors involved, genetic propensity seems especially important.

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