Five pediatric cases of ictal fear with variable outcomes.

Abstract:

PURPOSE:Ictal fear is an uncommon condition in which fear manifests as the main feature of epileptic seizures. The literature has suggested that ictal fear is generally associated with poor seizure outcomes. We wanted to clarify the variability in seizure outcome of children with ictal fear. SUBJECTS AND METHODS:We identified five pediatric patients with ictal fear who were followed up on at Okayama University Hospital between January 2003 and December 2012. We retrospectively reviewed their clinical records and EEG findings. RESULTS:The onset age of epilepsy ranged from 8 months to 9 years and 10 months. The common ictal symptoms were sudden fright, clinging to someone nearby, and subsequent impairment of consciousness, which were often accompanied by complex visual hallucinations and psychosis-like complaints. Ictal fear, in four patients, was perceived as a nonepileptic disorder by their parents. Ictal electroencephalograms (EEG) of ictal fear were obtained in all patients. Three showed frontal onset, while the other two showed centrotemporal or occipital onsets. Two patients were seizure free at last follow-up, while seizures persisted in the other three. A patient with seizure onset during infancy had a favorable outcome, which was considered to be compatible with benign partial epilepsy with affective symptoms. CONCLUSION:Ictal fear is not always associated with a symptomatic cause or a poor seizure outcome. It is quite important to make a correct diagnosis of ictal fear as early as possible to optimize treatment.

journal_name

Brain Dev

journal_title

Brain & development

authors

Akiyama M,Kobayashi K,Inoue T,Akiyama T,Yoshinaga H

doi

10.1016/j.braindev.2013.11.011

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

758-63

issue

9

eissn

0387-7604

issn

1872-7131

pii

S0387-7604(14)00014-X

journal_volume

36

pub_type

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