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[Occipital paroxysms before eye closure. Clinico-electroencephalographic correlations in 24 cases]
1Departamento de Neuropsiquiatria da Faculdade de Ciências Médicas da Pontíficia Universidade Católica de Campinas (PUCCAMP), Brasil.
Insights
The electroencephalographic pattern of paroxysms of occipital events when eyes are closed (POEC) is not exclusive to childhood epilepsy. This EEG finding can occur in various epilepsy types and even in individuals without seizures.
Area of Science:
- Neurology
- Epileptology
- Clinical Neurophysiology
Context:
- The electroencephalographic (EEG) pattern known as paroxysms of occipital events when eyes are closed (POEC) is typically associated with childhood epilepsy with occipital paroxysms (CEOP).
- However, the association of POEC with idiopathic epilepsy has been debated.
- This study investigates the clinical and EEG characteristics of patients presenting with POEC.
Purpose:
- To analyze the electroencephalographic (EEG) and clinical features of 24 patients exhibiting paroxysms of occipital events when eyes are closed (POEC).
- To determine the spectrum of epileptic syndromes associated with the POEC pattern.
- To clarify the diagnostic significance of POEC in epilepsy.
Summary:
- The study analyzed 24 patients (ages 3-25) with POEC, finding that 75% experienced epileptic seizures.
- EEG showed generalized discharges, rolandic spikes, or background abnormalities in some patients.
- Diagnoses included CEOP, benign childhood epilepsy with centrotemporal spikes, partial symptomatic/cryptogenic epilepsy, generalized idiopathic epilepsy, and febrile convulsions, with POEC also observed in non-epileptic individuals.
Impact:
- This research expands the understanding of the electroencephalographic (EEG) pattern of paroxysms of occipital events when eyes are closed (POEC).
- It demonstrates that POEC is not limited to specific childhood epilepsy syndromes but can be present across a broader range of epileptic and non-epileptic conditions.
- The findings suggest a need to reconsider the diagnostic specificity of POEC in clinical neurophysiology and epilepsy evaluation.
Abstract:
Paroxysms of high-amplitude spike-waves or sharp waves recurring rhythmically on the occipital areas when the eyes are closed (POEC) are primarily observed in childhood epilepsy with occipital paroxysms (CEOP). An association of this electroencephalographic (EEG) pattern with idiopathic epilepsy has been disputed. We studied EEG and clinical features in 24 patients (age ranging from 3 to 25 years) with POEC. The EEG showed generalized discharges in 8 cases, rolandic spikes in 4 and background abnormalities in 4 cases. Eighteen (75%) patients manifested epileptic seizures. The nonfebrile seizures (16 cases) were partial (9 cases), generalized (6 cases) and unclassified (one patient). Two children had neurological examination or computed tomography abnormalities. Clinical and EEG data allowed for the following epileptic syndromes diagnosis: CEOP, 7 cases; benign childhood epilepsy with centrotemporal spikes, one case; CEOP or benign childhood epilepsy with centrotemporal spikes, one case; partial symptomatic/cryptogenic epilepsy, 4 cases; generalized idiopathic, 2 cases; febrile convulsions, 2 cases. We conclude that POEC may be observed in cases with different types of idiopathic partial, cryptogenic/symptomatic and idiopathic generalized epilepsies and may also occur in patients with no seizures.