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In the most recent ILAE-proposed Epilepsy Classification, epilepsia partialis continua (EPC) is classified into focal status epilepticus among continuous seizure types, and defined simply as a combination of focal seizures with continuous twitching in the same area correlated with Rasmussen syndrome, focal cerebral lesions of miscellaneous causes, or inborn errors of metabolism. EPC is most frequently encountered in chronic neurological conditions, for example Rasmussen syndrome, symptomatic focal epilepsy due to focal cortical dysplasia, and mitochondrial encephalopathy. EPC also occurs in patients with focal cortical dysplasia involving the sensorimotor cortex as well as in hemimegalencephaly. The epileptic seizures including EPC are generally resistant to antiepileptic drug (AED) therapy, but neurological deterioration is not evident except for that seizure-generated. Scanning with magnetic resonance imaging (MRI) can detect focal cortical dysplasia in the sensorimotor cortex with or without involvement of the adjacent cortex.
The aim of this paper is to promote the correct classification of, and provide guidelines on, the diagnosis and management of Panayiotopoulos syndrome (PS). An international consortium of established researchers in the field collaborated to produce a consensus document. The resulting document defines PS, characterizes its electro-clinical features, considers its likely pathogenesis, and provides guidance on appropriate management. We conclude that PS is a common idiopathic, benign seizure disorder of childhood, which should be classified as an autonomic epilepsy, rather than an occipital epilepsy.
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