Tonic reflex seizures of early infancy

Abstract

During the first months of life, children can present with unusual movements, which need to be differentiated from epileptic seizures. Some occur spontaneously, others are induced by various external stimuli. In 2001, we described a new clinical entity, which we called tonic reflex seizures of early infancy [1]. The condition occurs in otherwise normal children, mainly boys, and usually during the second or more rarely the third month of life. In all cases described the preganancy and delivery was normal. The attacks consist of tonic contractions predominantly of the limbs provoked by shaking, tactile stimulation or sudden postural changes, whether involving forward, upward or downward movements obviously, such stimuli occur during normal childcare. Upright rhythmical movements appear to be particularly likely to provoke attacks and some mothers are aware of the likely occurrence of the attacks if they descend stairs while holding their child in a vertical position. The attacks themselves consist of a sudden sustained diffuse tonic contraction with extension and abduction of all four limbs,although most noticeable in the upper limbs. This is accompanied by apnea and cyanosis but no impairment of consciousness. Attacks usually last between 3 to 10 sec and are usually followed by a brief cry. They may be repeated if the stimulus is repeated the phenomenon