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All electroencephalograms performed in our institution between 1980 and 1990 were reviewed. The clinical characteristics of children with epilepsy and generalized spike-and-wave (SW) patterns were analyzed. The SW patterns were classified according to their frequency. Electroencephalograms of 154 children with epilepsy revealed SW patterns. Absence seizures were the most common first seizure, but partial seizures were frequent. More than 40% had several types of seizures. Sixty percent of the epileptic syndromes were generalized, but almost 25% were partial. The typical SW pattern was associated with absence seizures, a normal examination and computed tomographic scan, idiopathic generalized epilepsies, monotherapy, freedom from seizures, and lack of recurrence. The slow SW pattern was associated with West syndrome; a younger age at seizure onset; atonic, myoclonic, tonic, and partial simple seizures; an abnormal examination and computed tomographic scan; cryptogenic or symptomatic generalized epilepsy or symptomatic partial epilepsy; polytherapy; and poor seizure control. The fast SW pattern was associated with secondary generalized, partial, tonic-clonic, and complex partial seizures; a normal computed tomographic scan; cryptogenic partial epilepsy; isolated seizures; and seizure recurrence. Epilepsy with a typical SW pattern should be considered benign, epilepsy with a slow SW pattern malignant, and epilepsy with a fast SW pattern treacherous.

Objective: The purpose of this study was to determine the clinical relevance of electroencephalograms (EEG) with generalized spike-wave (S-W) in pediatric patients, especially in children with febrile seizures., Patients and Methods: One hundred and seventy pediatric patients with S-W were found from a register of 39,322 consecutive EEGs performed in an EEG laboratory dedicated to general clinical practice. Patients that only suffered febrile seizures were not considered epileptic., Results: Of the 170 patients, 154 (90.6%) were epileptic and 16 (9.4%) were not. Mean follow-up was 4.5 years. Twelve of the 16 non-epileptic children with S-W suffered febrile seizures., Conclusions: The presence of S-W in EEGs is uncommon. Almost 10% of the children with S-W were not epileptic patients and none of them suffered from epilepsy during the follow-up period. Performance of an EEG on a child without epilepsy, especially those with febrile seizures, can be a factor of confusion.

Introduction: Epilepsy is a chronic disorder. The prognosis of one particular subtype, that of children with generalized spike and wave discharges (P-O) on the electroencephalogram (EEG), is unknown., Objective: To determine the prognosis of children with epilepsy with P-O on EEG and the factors which affect this., Patients and Methods: All EEGs done over ten years (39,322) were reviewed, and the epileptic patients under 14 years old identified. Absence and recurrence of crises were evaluated and the factors influencing them analyzed. Minimum significance was p < 0.05. The chi square test, Student's t test and Kaplan-Meier method were used. Logistic regression models were devised., Results: Of the children studied, 78% became crisis-free. After monovariant and multivariant analysis the only conditions which fitted the regression models were: abnormal pregnancy; West syndrome or learning difficulties; having certain types of crises, myoclonic, clonic-tonic, partial simple or complex crises; a normal EEG with hypsarrhythmia, slow or fast P-O and requiring multiple medication. When medication ceased, 31.4% had recurrence of the episodes. On monovariant and multivariant analysis, protective factors were absence of attacks and risk factors were a family history of epilepsy or an EEG with rapid P-O., Conclusions: The overall prognosis for epileptic children with P-O is good. There are factors which improve or worsen the pronosis, but these cannot be modified.