Normally developed infant with a suppression burst pattern on electroencephalography in the neonatal period.

The background activity on neonatal electroencephalography (EEG) is a good prognostic indicator. An EEG suppression burst pattern usually indicates severe brain dysfunction and has been considered to be associated with a serious neurodevelopmental outcome. We report here a 2-year-old girl who developed generalized convulsions without any perinatal brain insult at 3 days of age. At that time, her EEG constantly showed a suppression burst pattern, and her prognosis was considered to be poor. However, her seizures were well controlled with the oral administration of carbamazepine, and the suppression burst pattern on EEG disappeared at 27 days of age. Unexpectedly, she developed normally for the following 2 years. Although children with normal development, despite the appearance of suppression burst, are extremely rare, and the reason why this patient showed a favorable outcome remains unknown, the clinical course of this patient proved that an EEG suppression burst pattern is not always associated with a poor prognosis.

Persistent hyperinsulinemic hypoglycaemia followed as benign infantile convulsion.

An 18-month-old boy developed seizures at 3 months of age. He developed normally and, his EEG and brain CT revealed no abnormal findings. The blood sugar level was normal at that time, thus he was diagnosed as having benign infantile convulsion. At 7 months of age seizures reappeared, and hypoglycaemia associated with hyperinsulinism was observed during the seizures. With conservative therapy his blood sugar level was well controlled and he had no further seizures. Hypoglycaemic seizures are sometimes misdiagnosed as epilepsy. We have to pay attention to hyperinsulinemic hypoglycaemia when we see seizures with normal EEG even in infants.