Reactive Occipital Epileptiform Activity: Is It Benign?

Abstract

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.

Early Onset Benign Childhood Occipital Epilepsy (Panayiotopoulos Syndrome). A Case Report

“…Эти пароксизмы устраняются или заметно уменьшаются, когда глаза открыты [25,32,33]. Это яв-ление считается патогномоничным для синдрома Гасто, однако имеются сообщения о возникновении данного феномена у пациентов с синдромом Панайотопулоса и с другими формами эпилепсии [6,23].…”

“…На ЭЭГ могут отмечаться затылочные спайки и волны, исчезающие после от-крывания глаз, что характерно для детской затылоч-ной эпилепсии типа Гасто и может отмечаться при синдроме Панайотопулоса [6,23].…”

Childhood Epilepsy With Occipital Paroxysms: Clinical Variants in 134 Patients

“…Studies based on EEG selection criteria showed that CEOP accounted for 6-72% of the cases (11,(43)(44)(45)(46). Moreover, some patients may have EEG findings without a clinical seizure (11,42,44,45,47,48). Thus, it is important to stress that the diagnostic criteria for CEOP should be based on the finding of occipital spikes on the EEG and a clinical seizure in the absence of neurological deficit or neuroradiological evidence of brain damage, although the EEG findings may not always present in the interictal EEG of patients with CEOP (1,9,13,14,38,49).…”

“…The presence of occipital spike waves suppressed by eye opening, one of the criteria in the first report of Gastaut (1), is associated with a wide range of clinical disorders, including lesional epilepsy and learning disabilities (41,42). Studies based on EEG selection criteria showed that CEOP accounted for 6-72% of the cases (11,(43)(44)(45)(46).…”

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“…[8][9][10][11][12][13][14][15][16] Panayiotopoulos-type benign childhood occipital epilepsy (Panayiotopoulos-type CEOP), as we have proposed to name 12,14 the entity-which currently is being considered for inclusion in a revised classification of epileptic syndromes and diseases by the ILAE 2,17 -has uniform clinical and EEG features and excellent prognosis. The syndrome may be underdiagnosed in the United States, as indicated in recent reports, [18][19][20] or misdiagnosed as encephalitis, other serious brain insults, or migraine. The seizures mainly consist of ictal vomiting and deviation of the eyes, often with impairment of consciousness and progression to convulsions.…”