Proposal for panayiotopoulos syndrome criteria

Panayiotopoulos syndrome (PS) occurs commonly and is recognized by most authors, but there is hardly a diagnostic criterion for the condition that would not absolutise some clinical or electroencephalographic symptom. The AIM of the present study was to introduce and investigate clinical criteria for Panayiotopoulos syndrome that lack a mandatory symptom.

A group of 34 cases with idiopathic partial epilepsy was selected among 170 children with epilepsy. The children were diagnosed and treated at the Pediatric Neurology Unit at the Department of Pediatrics and Medical Genetics, Medical University, Plovdiv. The following 8 criteria for Panayiotopoulos syndrome were applied to them: infrequent seizures (up to 5), prolonged seizures (> 5 min.), ictal vomiting, ictal eye deviation, ictal autonomic manifestations, ictal behavioural disturbances, gradual suppression of consciousness during seizures; convulsions.

The distribution of the 34 cases by number of criteria they met was as follows: a single child met 8 criteria for PS, another child met 7 criteria, 2 children satisfied 6 criteria, 8 children - 5,2 children - 4,2 children - 3, 7 children - 2, 10 children - 1 and one child - 0 PS criteria. Cases with 5 or more positive criteria were recognized as Panayiotopoulos syndrome. One of the two cases satisfying 4 criteria was additionally included in the PS group after consultation. The clinical and electroencephalographic manifestations of the group of children with Panayiotopoulos syndrome did not differ from those of previously reported cases in the literature.

Panayiotopoulos syndrome can be reliably differentiated from other cases of idiopathic partial epilepsy by the presence of at least 5 of the 8 criteria presented above.