Chapter 12 - Idiopathic generalized epilepsies

Summary

Idiopathic generalized epilepsies (IGEs) are the commonest group of epilepsies in children and adolescents. IGE syndromes are defined by distinct age at onset, seizure types, and characteristic electroencephalogram (EEG) abnormalities, without structural brain lesions and with normal developmental skills. The EEG shows normal background activity; focal interictal EEG abnormalities, occasionally reported, are not a consistent feature of benign myoclonic epilepsy of infancy (BMEI). Myoclonic-astatic epilepsy epitomizes a spectrum of IGEs with prominent myoclonic seizures, appearing in previously healthy children. Absence epilepsies and more broadly IGEs can sometimes cooccur with paroxysmal movement disorders. The IGEs have a predominant genetic etiology and current data are in favor of a complex model of inheritance with the interaction of two or more genes. Subtle developmental abnormalities of brain architecture are described in patients with IGE. New-generation antiepileptic drugs have been proven to be useful in the treatment of pharmacoresistant IGEs.