Paroxysmal events in infants: Persistent eye closure makes seizures unlikely

Objective. Paroxysmal events are frequent in infancy. A precise diagnosis is often difficult to assign despite adequate history and physical examination. Certain clinical signs may help to suggest the diagnosis, thereby avoiding unnecessary and costly investigations. The aim of this study was to determine the frequency of eye opening during infantile seizures and evaluate the potential usefulness of this simple observation in the differential diagnosis of acute events in infants. Methods. We performed a retrospective video electroencephalogram review of the seizures recorded in infants at our Epilepsy Center, paying specific attention to eye opening. Results. Ninety-one seizures in 69 infants were included. Eyes were open in 85 (93.4%) cases. Conclusions. Infants whose eyes are closed throughout the paroxysmal event are most likely not having seizures.