Pure Petit Mal (Absence) Clinical and Electroencephalographic - Studies- Tohru SEKI, M. D., Itoko MORI, M. D., Setuko SUGIURA, M. D., Nobuko INADA, M. D., Mototugu KYO, M. D., Yo shihumi YAMAMOTO, M. D. and Yukio FUKUYAMA, M. D. (Department of Pediatrics, Tokyo Women's Medical College, Tokyo (Director: Prof. Y. FUKUYAMA)) This report was based on 37 cases with pure petit mal (absence), which were observed at the Departments of Pediatrics of Tokyo Women's Medical College, Keio University, and at the Section of Neurology, National Children's Hospital, from April 1967 to August 1971. 1) The onset of the illness occurred mostly between the fourth and ninth years of life. Two thirds of the affected cases were girls. 2) Twenty-three cases (62.2%) were not preceded by other epileptic seizures, 12 cases (32.4%) had grand mal or febrile convulsion (mixed form by Fukuyama) prior to the onset of pure petit mal. 3) The material was classified according to the clinical manifestation during the absence attacks. Absence (simple form) was abserved in 29 cases (78.4%). absence with automatism in 7 cases (18.9 %), absence with focal motor seizure in 1 case (2.7%). 4) As to the EEG abnormalities in addition to the burst of bilateral synchronous 3 c/s spike and wave complex, focal spikes were observed in 3 casas (r-frontal region in 2 cases, r-antetemporal region in 1 cases), focal spike and wave complex (ć-occipital region) in 1 case. The background activity showed the slightly or moderately diffuse irregular slow waves in 22 cases (59.5%), and this pattern was commonly seen in cases associated with grand mal or febrile convulsion. 5) Of 23 cases who had been followed for at least three years after the initial attack of absence, 3 cases (13.0%) developed subsequent grand mal. This percentage was rather lower than the results of previous studies. Twenty cases (87.0%) had ceased to have pure petit mal and other epileptic attacks clinically, 2 cases continued to have pure petit mal, 1 case to have both grand mal and pure petit mal.
6) Seven cases were tested with repetitive systemic injections otismall doses (1mg/kg) of thiopental sodium, postulating that the test might be able to differentiate primary or secondary bilatral synchrony. The most common EEG response obtained among subjects was of type. I which was considered characteristic for primary bilateral synchrony according to Lombroso's description. to be Absence, EEG, Primary bilateral synchrony, Secondary bilateral synchrony. Definition of pure Petit Mal (Absence)
Equivocal response (Type 4) good induction of beta rhythms, with persistence or activation of the bilateral spike & wave discha rges; or a questionable indication of focal elements, etc. klombroso C T et al25) l
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