Complex partial seizures of infancy.

Ictal manifestations of complex partial seizures in infancy have not been described previously. Using long-term video/electroencephalographic and telemetric monitoring techniques, 187 seizures were recorded in 14 infants under 2 years of age. With one exception, the infants were profoundly delayed with intractable seizures. Nine had marked bilateral abnormalities on computed tomographic scan. The seizure manifestations noted most frequently consisted of behavioral arrest with forced lateralized deviation of the head and eyes and tonic upper-extremity extensor stiffening. Complex facial automatisms such as chewing, sucking, mouthing, and blinking were relatively common. Ictal paroxysmal onset was always lateralized on electroencephalograms, whereas the interictal recordings revealed multifocal epileptic discharges, generalized slowing, and voltage attenuation. The ictal behavioral manifestations and electric seizure patterns were quite distinctive yet were often undiagnosed on routine evaluations.