Abstract

Malignant migrating partial seizures of infancy (MMPSI) is a rare and usually an unrecognized epileptic syndrome of infancy. The first publication was presented by Coppola and colleagues in 1995, and Dulac in 2005 summarized 24 patients' followup in the Saint Vincent de Paul Hospital in Paris. Clinical cases have demonstrated a new epileptic syndrome, different from previously described forms of epileptic encephalopathies of infancy for the whole world of epileptology. Seizure onset before the age of 6 months but commonly start within a few weeks of birth. In the age of 1 to 10 months seizures become very frequent, polymorphic and usually get clustered nature; mental and motor retardation is clear observed. Clinical manifestation of seizures may include head and eyes version, lateralized clonic eyelid twitchings, fixed gaze, tonic tension or clonias of one limb or hemispasms, axial tonic spasms, chewing or sucking movements, episodes of apnea, flushing, hypersalivation, and secondary generalized seizures. MMPSI could be also considered as a special type of infantile status epilepticus. Video-EEG monitoring plays the most important role in the MMPSI diagnosis. Ictal EEG patterns involve different areas of the cerebral cortex of both hemispheres; initial zone of ictal patterns shifts from one region to another. MMPSI is a drug-resistant epilepsy with serious prognosis.

Keywords: malignant migrating partial seizures of infancy, Coppola-Dulac syndrome, status epilepticus in infancy, epileptic encephalopathy
