[Noninvasive video-EEG-monitoring in the diagnosis of focal epilepsy in children].

Unlabelled: Aims of the study include diagnosis of focal epilepsy, determination of localization of interictal and ictal epileptiform activity. 785 patients (age range -- 1 month-21 year) with admission diagnosis "epilepsy" were analyzed. Video-EEG-monitoring using a 21-chanel EEG system with duration 9-96 hours (mean -- 10 hours) was applied. The diagnosis of epilepsy was confirmed in 634 patients (80.8%) while in 151 patient (19.2%) non-epileptic paroxysms were diagnosed. Generalized epilepsy (GE) was diagnoses in 47 cases (7.4%), focal (FE) -- in 587 (92.6%) cases. According to localization, distribution was the following: frontal -- 48.2%, temporal -- 30.8%, occipital -- 10%, parietal -- 5.5%, multifocal -- 5.5%. 45% of patients with FE younger than 3 years had marked generalized seizures known as infantile spasms. Among 587 patients with FE discrepancy of localization of interictal focus and zone of seizure onset was found in 41 cases (7%), mainly in younger patients. In 14 cases (2.4%) we observed more than one zone of seizure onset: 2 -- in 13, 3 -- in 1, both in frontal and left temporal areas (all specified patients are from the younger group).

Conclusions: 1) every fifth patients with primarily diagnosed epilepsy does not suffer from this disease; 2) 92.6% of patients in pediatric epileptologic clinic have FE, about half of them have frontal localization of the focus; 3) presence of generalized types of seizures mimicking GE is an important feature of FE in younger patients; 4) In some patients with FE, especially in younger ones, discrepancy of localization of interictal epileptiform activity and zone of seizure onset is found, we also observed that more than one zone was producing attacks. The specified features are necessary for consideration during preoperative assessment.