Tonic reflex seizures of early infancy: an age‐related non‐epileptic paroxysmal disorder

ABSTRACT Non‐epileptic paroxysmal disorders (NEPD) include a heterogeneous group of disorders that can be confused with epileptic manifestations. They occur very frequently in the first year of life and are expressed predominantly as unusual movements. We report the clinical and EEG‐polygraphic characteristics of 13 patients (nine male, four female) that we observed between 1988 and 1999, who presented non‐epileptic tonic reflex seizures in the first months of life. All children had normal psychomotor development with no neurological antecedents. Onset of manifestations occurred between the first and third month of life. The seizure was characterized by diffuse tonic contraction with extension of four limbs, apnoea and cyanosis, and lasted 3‐10 sec without loss of consciousness. Seizures occurred only while the child was awake and being held in a vertical position by an adult, and were triggered by movement or tactile stimulation. Ictal and interictal EEG were normal. Prognosis was benign with spontaneous remission within 2 months of onset. In our experience, this paroxysmal manifestation has not been described previously by other authors and represents a new NEPD which, in accordance with our first report of this entity, we suggest calling tonic reflex seizure of early infancy (TRSEI). (Published with videosequences.) Content available: Video