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Panayiotopoulos syndrome: a prospective study of 192 patients
Roberto Caraballo1, Ricardo Cersósimo, Natalio Fejerman
1Hospital Nacional de Pediatria Juan P. Garrahan, Buenos Aires, Argentina. rhcaraballo@arnet.com.ar
Insights
Panayiotopoulos Syndrome (PS) is a distinct childhood epilepsy characterized by autonomic symptoms and seizures, often occurring during sleep. This study defines its electroclinical features and excellent prognosis.
Area of Science:
- Neurology
- Pediatric Neurology
- Epileptology
Background:
- Panayiotopoulos Syndrome (PS) is a common childhood epilepsy syndrome.
- Benign childhood epilepsy with centro-temporal spikes (BCECTS) is another common epilepsy syndrome in children.
Purpose of the Study:
- To characterize the electroclinical features and evolution of Panayiotopoulos Syndrome (PS).
- To compare the incidence of PS with BCECTS.
Main Methods:
- Prospective identification and follow-up of children meeting electroclinical criteria for PS.
- Clinical evaluation, sleep, and awake EEG recordings were conducted between February 1990 and 2006.
Main Results:
- 192 patients with PS were identified, compared to 398 children with BCECTS.
- Autonomic manifestations, ictal eye deviation, and generalized convulsions were frequent in PS.
- Seizures predominantly occurred during sleep (98%), with one-third experiencing awake seizures; 33% had partial status epilepticus.
Conclusions:
- PS is less common than BCECTS but is well-defined and recognizable by clinical and EEG findings.
- Autonomic manifestations are a hallmark ictal event in PS.
- PS has an excellent prognosis, with most patients experiencing few seizures.
Objectives:
To characterize the electroclinical features and evolution of Panayiotopoulos Syndrome (PS).
Methods:
Children with electroclinical criteria of PS were prospectively identified and followed-up clinically, and with sleep and awake EEGs between February 1990 and 2006.
Results:
We identified 192 patients with PS. In the same length of time 398 children with benign childhood epilepsy with centro-temporal spikes (BCECTS) were registered. PS had a peak age at onset of 5 years. Autonomic manifestations were one of the most common ictal event. Ictal deviation of the eyes and progression to generalized convulsions were also quite frequent. Approximately one third had partial status epilepticus. In all patients except five, the seizures occurred during sleep. One-third also had fits while awake. Sixteen children had concomitant symptoms of rolandic epilepsy and eight developed rolandic seizures after remission of PS seizures. Prognosis was excellent. Eighty-four (44.2%) had a single seizure, 79 (41.2%) had 2-5 fits, and 28 (14.6%) had frequent seizures.
Conclusion:
PS is less common than BCECTS, but is well defined and easily recognizable by clinical and EEG features, with autonomic manifestations as one of the most common ictal event.
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