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Clinical Pediatrics
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Apparent Life-Threatening Episodes as the First Manifestation of Epilepsy

Magda Lahorgue Nunes, MD, PhD

Divisions of Neurology, Pediatrics and Neurophysiology, Hospital São Lucas—PUCRS School of Medicine, Porto Alegre, RS, Brazil

Carla Calcagnoto Appel, MD

Divisions of Neurophysiology, Hospital Sao Lucas, PUCRS School of Medicine, Porto Alegre, RS, Brazil

Jaderson Costa da Costa, MD, PhD

Divisions of Neurology and Neurophysiology, Hospital São Lucas—, PUCRS School of Medicine, Porto Alegre, RS, Brazil

Apparent life-threatening episodes (ALTE) can be the first manifestation of an epileptic seizure in children. However, the diagnosis of ALTE is generally delayed because the interictal EEG often appears normal and the presence of gastroesophageal reflux may mislead the diagnosis of the epileptic manifestation. We report 6 children with epilepsy who presented an ALTE as their first seizure manifestation. The retrospective analysis of our cases demonstrated that ictal EEGs, when available, appeared to be the most helpful test to confirm the diagnosis, although an abnormal-appearing cerebral imaging was also contributive in the patients when only interictal EEGs were available.

Clinical Pediatrics, Vol. 42, No. 1, 19-22 (2003)
DOI: 10.1177/000992280304200103
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Home page
 J Child NeurolHome page
J. Genizi, G. Pillar, S. Ravid, and E. Shahar
Apparent Life-Threatening Events: Neurological Correlates and the Mandatory Work-Up
J Child Neurol, November 1, 2008; 23(11): 1305 - 1307.
[Abstract] [PDF]