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Correspondence

Indian Pediatr 2015;52: 623-624

Possible Benign Partial Epilepsy: Authors’ Reply


Devendra Mishra and Niraj K Nikunj

Department of Pediatrics, Maulana Azad Medical College, New Delhi, India.
Email: [email protected]

 
 


We thank the author for his comments. An abbreviated description of these cases had been provided because these cases were part of a larger study, which is under publication. The purpose of the report was to highlight this relatively under-reported entity [1]. Our responses follow:

1. We agree with the author’s contention. Two of the cases had secondary generalization, as mentioned in the original article also [1].

2. Three infants had a normal MRI brain (1.5T), whereas, due to financial constraints, one child underwent a non-contrast CT head. Normal neuroimaging had been mentioned in the original article [1].

3. We are unclear about what the authors mean by a metabolic and a genetic work-up. There is no single metabolic/genetic panel that may be ordered in all children with seizures. We followed standard guidelines for evaluation; metabolic profile to rule out inborn errors of metabolism was done only when indicated on the basis of history or examination findings, or results of other investigations. Genetic testing was only done, if there was a suspicion of a disorder on the basis of dysmorphology, seizure semiology, family history, and associated clinical findings. Otherwise, genetic testing is likely to be a low-yield strategy.

4. We agree that we should take a directed history of diarrhea in infants with clusters of seizures. None of these had such a history. In fact, we have previously reported one patient with Benign infantile seizures with mild gastroenteritis, who was diagnosed during the same study [2].

5. We agree that a definite diagnosis may only be possible later; however, most of the literature is still of the view that treatment with anti-epileptic drugs is not mandatory [3]. In fact, in the study referred to by the author [4], the definite diagnosis could be made for more than three-fourth of those initially diagnosed as having ‘possible’ Benign partial epilepsy of infancy. The ‘possible’ terminology; however, has no scientific sanction.

References

1. Mishra D, Nikunj NK, Juneja M, Talukdar B. Benign infantile seizures.Indian Pediatr. 2015;52:151-2.

2. Mishra D, Nikunj NK. Benign infantile seizures with mild gastroenteritis. Indian Pediatr. 2014;51:585-6.

3. Caraballo RH, Cersósimo RO, Amartino H, Szepetowski P, Fejerman N. Benign familial infantile seizures: Further delineation of the syndrome. J Child Neurol. 2002;17:696-9.

 

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