The classification of epilepsies includes epilepsy with occipital paroxysms among the age-related focal idiopathic forms. Although not exclusive to this syndrome, occipital EEG paroxysms are considered both typical and necessary for diagnosis. Seizure semiology can vary depending on spreading of ictal discharge, yet versive seizures associated with vomiting and impairment of consciousness seem to be typical of younger children and correlate with a better prognosis. We studied 24 patients aged 3 years 6 months to 20 years (mean 9y10m) with this syndrome, with a clinical and EEG follow-up of 1-10 years (mean: 4y9m). In 7 patients, EEG abnormalities fluctuated over time and sometimes were present only in the 24 hours following a seizure (3 patients) or, on the contrary, appeared 3-9 months after the first seizure (3 patients) to remain or disappear in the following months. Such fuctuations, which occurred in an age range (2 years 6 months-11 years) in which the disease is active, could not be attributed to drugs and were found in patients with particularly benign prognosis, 5 of whom had the ictal pattern of versive seizures with vomiting. At least in some cases of idiopathic occipital epilepsy, the overall clinical criterion, seizure sensiology and background EEG are sufficient for a diagnostic suspicion and the 'occipital paroxysms' are an accessory element. Inclusion restricted to patients with EEG paroxysms may have caused an underestimation of prevalence, as well as the selection of patients with a greater number of seizures, in the series reported to date.
|Translated title of the contribution||Childhood idiopathic occipital epilepsy: Limits and uncertainty of EEG diagnosis|
|Number of pages||14|
|Publication status||Published - 1995|
ASJC Scopus subject areas
- Clinical Neurology