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[Benign childhood occipital epilepsy: evolution of the occipital spikes]
M A Martín Santidrián1, M T Sousa Vicente, C Ruiz Espinoza
1Unidad de Neuropediatría, Hospital de Cruces, Barakaldo, Vizcaya, Spain.
Insights
Occipital spikes in benign occipital epilepsy persist longer than seizures. Ictal vomiting is linked to earlier onset and longer duration of these EEG discharges, indicating a later remission.
Area of Science:
- Pediatric Neurology
- Epileptology
- Electroencephalography (EEG)
Context:
- Benign occipital epilepsy is a childhood epilepsy syndrome characterized by occipital EEG discharges.
- Understanding the electro-clinical evolution of these discharges is crucial for prognosis and management.
Purpose:
- To analyze the electro-clinical evolution of occipital EEG discharges in benign occipital epilepsy.
- To investigate the influence of age, sex, epilepsy course, and treatment on EEG discharge evolution.
Summary:
- A retrospective study of 30 patients with benign occipital epilepsy analyzed EEG foci onset, migration, and disappearance.
- Occipital spikes appeared earlier with ictal vomiting or longer seizures.
- Visual aura or prior febrile seizures were associated with later spike onset; anterior foci predicted later remission.
Impact:
- Occipital spikes persist longer than clinical seizures.
- Ictal vomiting is a significant predictor of specific EEG features, including early onset, prolonged evolution, and late remission of discharges.
- Findings aid in predicting epilepsy course and tailoring treatment strategies for pediatric epilepsy patients.
Purpose:
We studied the electro-clinical evolution of the occipital EEG discharges characteristic of partial benign epilepsy of childhood with occipital paroxysms. The influence of age, sex, epilepsy course and treatment on the evolution of this electrical event were analyzed.
Methods:
A longitudinal retrospective study that included 30 patients who fullfilled the diagnostic criteria of benign occipital epilepsy proposed by the ILAE. The onset, migration and disappearance of EEG foci were analyzed using the Pearson coefficient and non-parametric tests.
Results:
Occipital spikes are found earlier when vomiting is an ictal symptom (p < 0.01) or longer seizures (p = 0.05). Patients with and antecedent of febrile seizures or with an visual aura show a later onset of occipital spikes (p < 0.05). Ictal vomiting is associated with a longer persistence of occipital spikes along the years. Migration of EEG foci to anterior regions is characteristic of early onset seizures and predicts a later remission (p < 0.05). Extraoccipital foci are associated with a high seizure and occipital spike recurrence rate.
Conclusions:
Occipital spikes persist longer than seizures. Ictal vomiting is the only symptom related to specific EEG features: early onset, longer evolution and late remission of EEG discharges.