Epilepsy syndromes undetermined whether focal or generalized in infants

PurposeTo describe the seizures in infants with epilepsy syndromes undetermined whether focal or generalized.MethodsThis was a retrospective video-EEG study of seizures recorded at Children's Memorial Hospital (CMH), Chicago, IL, in infants diagnosed with epilepsy syndromes undetermined whether focal or generalized.ResultsOf 69 infants with seizures recorded, 23 (33%) had epilepsies undetermined whether focal or generalized with both generalized and focal seizures, 17 of which (25% of the total) had epilepsies with both focal and generalized seizures not further specified. The predominant seizure type was spasms with focal seizures.ConclusionsWe propose several small modifications to the existing 1989 ILAE epilepsy syndrome classification: epilepsies with both focal and generalized seizures could be re-labeled “pleomorphic epilepsies” for simplicity and should include idiopathic and symptomatic subgroups. We believe these epilepsies are not uncommon in the group of infants with intractable seizures and may have yet to be discovered metabolic and genetic determinants.