Infantile Epilepsy with Occipital Focus and Good Prognosis

Beaumanoir, A

doi:10.1159/000115535

Cited by 56 publications

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“…This was followed by alteration of consciousness and eye deviation. This overlap of ictal visual symptoms and tonic eye and head deviation in the same patients has been reported previously (3,5,11,14,33). Patients with visual symptoms and without adversive manifestations accounted for only 3.7% of the entire cohort, as also reported in one study (11).…”

Section: Figsupporting

confidence: 86%

“…Hemiconvulsion or secondary generalization often follows (3). However, in our study, in which 29 patients had seizures with motor semiology, presumably representing ictal spread to motor regions (3,37), the sequence of the electroclinical events was not recorded with video-EEG. Therefore, it is possible that the 11 patients who had nocturnal secondary generalized seizures may belong to the early-onset type, as may any of the other patients whose initial adversive stage was not witnessed or was not manifested.…”

Section: Figmentioning

confidence: 77%

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Childhood Epilepsy With Occipital Paroxysms: Clinical Variants in 134 Patients

2000

Epilepsia

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Summary:Purpose: In its recent proposal, the Commission on Classification and Terminology of the International League Against Epilepsy classified childhood epilepsy with occipital paroxysms (CEOP) into two syndromes with different predominant seizure types: early onset (Panayiotopoulos type) with eye deviation and ictal vomiting and late onset (Gastaut type) with initial ictal visual symptoms. We documented the clinical features of a large group of patients with CEOP to confirm whether the classification is justified.Methods: A file review of all patients with partial-onset seizure and interictal occipital spikes referred to our pediatric seizure unit between January 1975 and May 1997 yielded 134 who met the criteria for CEOP. Data were collected with a specially developed protocol and classified according to the two International League Against Epilepsy systems: (a) seizure classification, to test age-specific differences associated with the predominant seizure type, and (b) syndrome classification, to determine whether the clusters of signs and symptoms are sufficiently delineated.Results: Three groups were defined according to the predominant ictal manifestations. Group 1 (visual) consisted of 24 patients (17.9%) with ictal visual symptoms; 19 (14%) of these patients also had overlapping adversive manifestations, either as a separate seizure or as part of the same event (median age at first and last seizure, 7 years 11 months and 10 years). Group 2 (adversive) consisted of 72 patients (53.7%) with tonic eye deviation (median age at first and last seizure, 5 years 2 months and 7 years 2 months). Group 3 (nonvisual, nonadversive) consisted of 38 patients (28.4%) with various seizure spread patterns (median age at first and last seizure, 6 and 7 years 2 months). Two syndromes were identified. The Gastaut type included all 24 patients in the visual group (group 1); seizures were brief and frequent and were diurnal in 83%. The Panayiotopoulos type included all 72 patients in group 2; ictal eye deviation occurred in 100% of the patients and ictal vomiting in 44%; prolonged seizures were observed in 35% and were more frequent in patients who had ictal vomiting than in those who did not (46.8% versus 25%, respectively; p < 0.027). Seizures were infrequent; 24% of patients had a single seizure and 58% had nocturnal seizures. Onset was earlier than for the Gastaut type (p < 0.002). The 38 patients with nonoccipital manifestations did not satisfy the criteria for the complete form of either syndrome.Conclusions: The most common type of CEOP, the Panayiotopoulos type, is characterized by a cluster of signs and symptoms sufficiently delineated to justify their separate classification from Gastaut-type CEOP, despite the absence of ictal vomiting in more than 50% of the patients.

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Section: Figsupporting

confidence: 86%

Section: Figmentioning

confidence: 77%

Childhood Epilepsy With Occipital Paroxysms: Clinical Variants in 134 Patients

2000

Epilepsia

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“…In five cases there was no recurrence whatsoever, and in the other four (cases 1, 2, 5, 6) there were subsequently a few seizures, none of them severe. In five cases (1,3,7,8,9) treatment has already been discontinued with no recurrence. The seizures in BOE are often brief, especially when occurring on waking and sometimes even without loss of consciousness.27 Prolonged seizures lasting from 45 minutes to three hours have been mentioned in some reports.2412 Panayiotopoulos9 found in 16 patients that "consciousness was preserved throughout the ictus in four patients.…”

Section: Discussionmentioning

confidence: 98%

Stormy onset with prolonged loss of consciousness in benign childhood epilepsy with occipital paroxysms.

Kivity

Lerman

1992

Journal of Neurology, Neurosurgery & Psychiatry

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In nine of 62 children with benign occipital epilepsy (BOE) the onset was stormy and alarming. The first and often only seizure was characterised by prolonged loss of consciousness lasting up to 12 hours, suggesting an acute cerebral insult. In all but one case there was a tonic adversion either of eyes alone or of both head and eyes which was interpreted as conjugate deviation. The other accompanying ictal motor phenomena were either partial or generalised convulsions. In five patients the seizure was heralded by a headache, and in five cases was accompanied by vomiting. The seizure began with visual symptoms in only one patient. The seizure occurred while awake in seven and during sleep in two. The age at onset was from 3+ to 10 years. Interictal EEGs showed occipital discharges typical of BOE, and the clinical course was benign. In four cases a few partial or complex partial seizures recurred during subsequent anticonvulsant therapy, but in five cases seizures never recurred. Anticonvulsants were discontinued in five patients who remained free from seizures for one to Ili years after withdrawal of treatment. Sudden coma in a child associated with focal features such as tonic deviation of the head or eyes or both may represent a benign seizure disorder.

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“…"Childhood epilepsy with occipital paroxysms" (CEOP) is recognized as a localization-related, idiopathic epilepsy syndrome manifested by partial seizures beginning with visual symptoms (Commission, 1985). Patients with CEOP have been reported by Gastaut (1985;Gastaut & Zifkin, 1987) and other investigators (Beaumanoir, 1983;Beaumanoir and Grandjean, 1987;Niedermeyer et al, 1988) to have a good progseizures, and ROEA has also been associated with a benign course and good prognosis (Camfield et al, 1978;Panayiotopoulos, 1980;Terzano et al, 1987).…”

mentioning

confidence: 82%

Reactive Occipital Epileptiform Activity: Is It Benign?

Cooper

Lee

1991

Epilepsia

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Occipital epileptiform activity that is almost continuous and reactive to eye opening has been associated with a childhood epilepsy syndrome and basilar migraine with seizures. An association of these syndromes with a benign course had been disputed. In this study, a retrospective investigation of reactive occipital epileptiform activity (ROEA) was performed to determine the prognostic value of this distinctive EGG pattern. The EEG and hospital record of patients with ROEA were reviewed with an observation period of 6 months to 8 years. The patients were divided into good and poor outcome groups based on response to treatment. Of 33 patients, 12 (36.4%) had complete seizure control; 21 (63.6%) continued to have poorly controlled seizures. Only 3 (9.1%) patients were able to discontinue antiepileptic drugs (AEDs) without seizure recurrence. Analysis of clinical and EEG variables showed that a history of perinatal difficulties, abnormal neurologic findings, and abnormal EEG background activities occur significantly more frequently in the poor outcome group. This study suggests that ROEA is not uniformly associated with a benign course and that other factors are involved in determining prognosis of the epilepsy.

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Infantile Epilepsy with Occipital Focus and Good Prognosis

Cited by 56 publications

References 0 publications

Childhood Epilepsy With Occipital Paroxysms: Clinical Variants in 134 Patients

Childhood Epilepsy With Occipital Paroxysms: Clinical Variants in 134 Patients

Stormy onset with prolonged loss of consciousness in benign childhood epilepsy with occipital paroxysms.

Reactive Occipital Epileptiform Activity: Is It Benign?

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