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      Epilepsia occipital benigna da infância de início precoce (tipo Panayiotopoulos): aspectos clínicos e eletrencefalográficos evolutivos em 14 crianças Translated title: Early-onset benign childhood occipital epilepsy (Panayiotopoulos type): clinical and electroencephalographic features in 14 children

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          Abstract

          Foram estudadas as características evolutivas clínico-eletrencefalográficas de 14 crianças com epilepsia occipital benigna da infância de início precoce (tipo Panayiotopoulos). O tempo médio de segmento foi 50,5 meses. A idade média na primeira crise foi 3,7 anos. O número total de crises foi até 3 crises em 11 casos, numerosas em 3; o período médio entre a primeira e a última crise foi 14,5 meses. Em 4 casos as crises tiveram duração prolongada, constituindo estado de mal parcial. Atividade epileptiforme (AE) occipital foi observada em todos os casos no primeiro EEG e, foi também, extra-occipital, em 3 casos. Houve bloqueio da AE occipital, pela abertura dos olhos, em 4 casos; em 3 casos foram observadas, também, pontas evocadas. O EEG normalizou-se em 9 casos, em um período médio de 29 meses.

          Translated abstract

          We studied clinical and electroencephalographic features of 14 children, age range of 2 -8 years, with no neurological or neuroradiological evidence of brain damage and with occipital epileptiform activity in the EEG. Seizures were numerous in 3 cases. Age at onset was between 1-7 years. In 4 cases the seizures last for more than 20 min. Spikes were observed in 6 cases and spike and slow-wave complex in 8. Discharges blocking by eyes opening were confirmed in 4 cases. Somatosensory evoked spikes by foot stimulation were observed in 2 cases. Autonomic and versive seizures are the main clinical manifestations of Panayiotopoulos syndrome. Discharges blocking by eyes opening are a less frequent feature.

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          Most cited references20

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          A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE Task Force on Classification and Terminology.

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            Benign childhood epilepsy with occipital paroxysms: a 15-year prospective study.

            Eighteen of 418 children who had onset of epilepsy before the age of 13 years showed clinical and electroencephalographic evidence of benign childhood epilepsy with occipital paroxysms. They represented one-fifth of all benign age- and localization-related idiopathic epilepsies seen. Some patients were followed as long as 15 years. There was a preponderance in females and peak age at onset of epilepsy was 5 years. In 16 children, the seizures were infrequent and sometimes prolonged and consisted mainly of tonic deviation of the eyes and vomiting, often with evolution to unilateral or generalized convulsions. Seizures were only nocturnal in 11 and nocturnal and diurnal in another 5 children. Prognosis was excellent; 5 children had only one fit. Remission usually occurred 1 to 2 years after onset and no seizures occurred after the age of 12 years. The remaining 2 children had frequent diurnal episodes consisting of visual hallucinations, postictal headache, and occasional nocturnal hemiconvulsions. Their prognosis was less favorable. Electroencephalographic abnormalities in all 18 patients consisted of repetitive spike and slow-wave discharges confined to the occipital regions and attenuated when the eyes were open. These outlasted clinical remission for many years, sometimes up to the age of 16. Fixation-off sensitivity was demonstrated frequently. Based on these findings, a unifying definition for benign childhood epilepsy with occipital paroxysms is proposed.
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              Vomiting as an ictal manifestation of epileptic seizures and syndromes.

              Twenty-four out of 900 adult and children patients with epilepsy, were found to have vomiting during an ictus. All the 24 patients were children before puberty with a similar clinical pattern consisting of partial seizures which were mainly nocturnal. Ictal vomiting was always concurrent with other epileptic manifestations, more often deviation of the eyes and impairment of consciousness. The initial part of the ictus was short or prolonged for hours with frequent "marching" to hemi-convulsions and generalised seizures. Seventeen of the 24 children suffered from benign childhood epilepsies (BCE) with complete remission in long follow-up. A significantly higher association was found between ictal vomiting and the syndrome of BCE with occipital spikes (p less than 0.001) but not with centro-temporal spikes (p less than 0.2). The recognition of this association may have important theoretical implications. On clinical grounds, it may prevent unnecessary investigations and undue concern.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                anp
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo )
                1678-4227
                June 2005
                : 63
                : 2b
                : 464-468
                Affiliations
                [1 ] Pontifícia Universidade Católica de Campinas Brazil
                Article
                S0004-282X2005000300018
                10.1590/S0004-282X2005000300018
                9e0b147c-bf01-4f4c-b262-b986d8fcbfb3

                http://creativecommons.org/licenses/by/4.0/

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                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-282X&lng=en
                Categories
                NEUROSCIENCES
                PSYCHIATRY

                Neurosciences,Clinical Psychology & Psychiatry
                idiopathic focal epilepsy,occipital epilepsy,electroencephalogram,epilepsia focal,EEG,occipital,atividade epileptiforme

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