ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ PHÂN LOẠI HỘI CHỨNG ĐỘNG KINH Ở TRẺ NHŨ NHI TẠI BỆNH VIỆN NHI ĐỒNG 1

Abstract

Background: Early-onset epilepsy in infancy represents a group of severe neurological disorders often associated with high risks of drug resistance, developmental delay, and early mortality. Detailed clinical profiling and syndrome classification are essential for optimized management.

Objective: To describe the clinical and paraclinical characteristics and classify epilepsy syndromes in infants with early-onset epilepsy.

Methods: A cross-sectional descriptive study was conducted on 100 pediatric patients (onset < 2 years old) at Children’s Hospital 1 from June to September 2022. Clinical features, EEG, brain MRI, and ILAE 2022 syndrome classifications were analyzed.

Results: Focal onset seizures were the most prevalent (52%), with 23 of these cases (44.2% of the focal group) evolving into bilateral tonic-clonic seizures; generalized onset seizures accounted for 38%. A significant proportion of patients exhibited developmental delay, accounting for 76% of the cohort. Hypoxic-Ischemic Encephalopathy (HIE) was identified as the most critical risk factor (8%). EEG was performed in 97% of patients, with 51.55% showing abnormalities (predominantly epileptiform discharges at 28.9%). Brain MRI revealed structural abnormalities in 74.2% of cases, most commonly ventriculomegaly/brain atrophy (23.7%) and cortical malformations (18.3%). According to ILAE 2022 criteria, developmental and epileptic encephalopathies (DEEs) represented the highest proportion (19%), followed by epilepsy syndromes with other specific etiologies (10%) and infantile spasms (7%). Epilepsy syndromes remained unclassified in 44% of cases.

Conclusions: Early-onset epilepsy in infancy exhibits heterogeneous features. The ILAE framework facilitates a systematic diagnostic approach and supports clinical management in pediatric patients.