Partial seizures of frontal origin and generalized spike-and-waves: A benign frontal epilepsy of childhood?

Stereotyped bicycling movements have been recorded during partial complex seizures of frontal-orbital origin in adults. We describe a 5 year-old child whose seizures, characterized by stereotyped bicycling movements associated with loss of consciousness, started at the age of 15 months. Awake-EEG recordings performed at the age of 2.5 years were normal, whereas two partial (right frontal) seizures were recorded during phase II of sleep. Neurologic, neuropsychologic and TC brain examination were normal. Treatment with phenobarbital or carbamazepine failed to control seizures which recurred about once a week. At the age of 3.5 years, 12 months after onset of montherapy with carbamazepine, generalized, rhythmic, 3 c/s spike-and-wave discharges were recorded on awake-EEG recording. Monotherapy with sodium valproate induced complete control of the seizures with disparition of the paroxysmal EEG abnormalities. A question arises as to whether a benign frontal epilepsy with generalized spike-and-waves exists.