Seizures in an atelencephalic infant. Is the cortex essential for neonatal seizures?
R. Danner, D. A. Shewmon and M. P. Sherman
Clinical and electrographic seizures were recorded in an infant with
atelencephaly. Because the infant had no cerebral hemispheres, the ictal
discharges were presumed to arise from the disorganized diencephalic
derivatives that occupied the entire supratentorial space. The case
provided strong support for the concept that, unlike epileptic seizures in
older patients, some types of neonatal seizures may originate and propagate
exclusively in subcortical structures. This may explain the striking
dissociation between the electrographic and behavioral aspects of seizures
occasionally observed in newborns, as well as the frequent intractability
of such seizures to standard anticonvulsants.
