Panayiotopoulos syndrome: epidemiological and clinical characteristics and outcome

The aim of this study was to analyse the epidemiological, clinical and evolutional characteristics of Panayiotopoulos syndrome (PS) in order to facilitate the diagnosis in daily clinical practice. Thirty-seven medical records of patients diagnosed with PS were reviewed and the epidemiological and clinical features, results of complementary studies and evolutional data were collected. Mean age at diagnosis was 5.4 years. Female/male ratio was 2.1. The majority of seizures occurred during sleep (67.2%). They usually begin with autonomic manifestations or vomiting (70.1%). Ictal eye and/or cephalic deviation and progression to partial or generalized convulsions were also quite frequent. EEG showed occipital spikes in 28 patients (75.7%). Besides, 71.3% of recurrences were observed in the first 6 months after diagnosis, and 82.9% of the patients had no seizures beyond 2 years from diagnosis. One patient with an atypical development was recorded. The PS is a relatively frequent epileptic syndrome in paediatric age, especially in pre-school children. Although its semiological sequence is fairly typical, the unspecific clinical and neurological characteristics complicate the diagnostic suspicion. Prognosis is excellent; however, it would be convenient to keep a strict evolutional follow-up in these patients as an atypical evolution might occur.