Richard Chin and colleagues' study (July 15, p 222)1 is an excellent springboard for future research into childhood convulsive status epilepticus (CSE). It would be further improved if details of the method of seizure analysis were published. This would assist others who might wish to replicate this study.The validity of naming seizures as focal or generalised has been questioned in this journal,2 but I presume that, by generalised CSE, Chin and colleagues mean "no evidence of focal onset".Most remarkable to me is the finding of only two instances of clonic CSE in 176 children with first-ever CSE, compared with 151 with tonic-clonic CSE. This is very different from the case in anoxic-epileptic seizures (AES)-ie, epileptic seizures induced by syncopes-where the epileptic component is almost always clonic.35 When CSE complicates AES (as it often does) it is also mostly generalised clonic.4 How do Chin and colleagues define tonic-clonic as opposed to clonic?Exact observation of the nature of a first episode of CSE must be difficult for families. What were the techniques of history-taking used? For example, were parents shown videos of clonic epileptic seizures (such as have been published3) for comparison with tonic-clonic CSE?Precise descriptions of semiology underpin genetic advances in childhood paroxysmal disorders, and the same must surely apply to epidemiological advances.
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