Le problematiche delle epilessie occipitali e delle condizioni cliniche ad esse connesse

Occipital lobe is a sensory motor integration and elaboration area connected not only with the surrounding areas but also with more distant regions such as the amygdala, hippocampus and mesial temporal lobe, possibly through the inferior longitudinal fasciculus. These anatomical connections of the occipital lobe with the surrounding areas may explain why an epileptic occipital discharge remains localised in the occipital lobe or spreads to the parietal lobe, temporal lobe or subcortical structures provoking secondary ictal discharge resulting in ictal events other than occipital manifestations, and why such discharges could give rise to secondary epileptogenesis. Consequently, seizure ictal manifestations may be extremely polymorphous. Occipital epileptic syndromes are polymorphous, as well. In fact, occipital epilepsies may be idiopathic and symptomatic, benign or drug resistant sometimes with a severe evolution towards an epileptic encephalopathy. Occipital epilepsies may be presenting symptom of several diseases such as progressive myoclonic epilepsies, mitochondrial diseases, diabetes mellitus and coeliac disease. Occipital epilepsies, have also several correlations with migraine with aura and with basilar migraine. Even though the occipital epilepsies may characterise so different diseases with so different aetiologies, their outcome is quite stereotyped, especially at the beginning, when the symptomalogy frequently simulates an idiopathic benign occipital epilepsy.