Basilar migraine? Seizures, and severe epileptic EEG abnormalities

We studied a 14-year-old boy with episodes of elementary visual hallucinations, blindness, and headache. Electroencephalogram (EEG) showed continuous spike and slow-wave activity, which was confined to the posterior regions; this was related to eyes closed or darkness, but it was inhibited when the patient opened his eyes in an illuminated room or during retained central vision in darkness. The clinical and EEG manifestations were easily controlled by antiepileptic drugs. This case resembles four cases of a recently reported benign syndrome of "basilar migraine, seizures, and severe epileptiform EEG abnormalities. Whether the syndrome is migrainous or epileptic has yet to be elucidated.