Four infants with partial seizures evolving to infantile spasms were investigated using simultaneous EEG-video-telemetry recording in the Dept of Pediatrics, Nagoya University, Nagoya, and Division of Pediatric Neurology, Central Hospital, Aichi Prefectural Colony, Kasugai, Japan. Partial seizures were characterized by cessation of activity, staring, flushing, automatisms, increased tone and laughter. 
COMMENT. A cry or scream is the most common ictal element in infantile spasms, and laughter and a frightened or confused expression, manifestations of partial seizures, are frequently described . The above report appears to be the first in which infantile spasms were preceded by partial seizures confirmed by EEG-VT. However, one of the above authors, in a previous study of the evolution of EEG abnormalities accompanying infantile spasms, reported hypsarrhythmia preceded by focal sharp wave patterns, compatible with partial seizures.