Abstract
This article aims to discuss if the underlying etiology is an important determinant
of atypical evolution of idiopathic focal epilepsy (IFE) in childhood and if there
might be biomarkers that would predict atypical evolution. It appears that the determinants
of atypical evolution remain largely unknown but that both genetic and epigenetic
factors are likely to be involved. The analysis of scalp electroencephalography remains
the best biomarker of atypical evolution. However, functional neuroimaging methods
of investigation are helpful to better understand how epileptic activity affects brain
functioning at rest and during goal-directed tasks and to delineate the extent of
brain networks that are impaired by epileptic activity. Moreover, neuroimaging bring
new arguments favoring the idea that typical and atypical IFE should not be viewed
as distinct entities but as a unique syndrome with various degrees of severity that
should be treated using tailored strategies and robust biomarkers of efficacy.
Keywords
epilepsy - focal - genetics - childhood - physiopathology - functional neuroimaging
