The characterization of childhood occipital epilepsy of Gastaut: a study of seven patients.

Characterization of the electroclinical features and evolution of childhood occipital epilepsy of Gastaut (COE-G). Seven children were retrospectively identified as having COE-G and were followed-up clinically using EEGs. Visual manifestations were the most common ictal event. Eye-associated ictal deviation was associated with ipsilateral turning of the head and migraine-like symptoms were frequent. Hemiconvulsions occurred in two children, and only one child had secondary generalized tonic-clonic seizures. In all patients, seizures occurred while awake, while two patients also had seizures while sleeping. EEG showed five patients with occipital spike-wave discharges when their eyes were closed which disappeared once their eyes were opened. Two cases continued having frequent seizures despite antiepileptic drug treatment. These patients also displayed learning difficulties and behavioral impairments after seizure onset. COE-G is a distinctive epileptic syndrome; however, the long-term prognosis for patients with the condition is unclear.

[Clinical and electroencephalographic features in children with benign occipital epilepsy].

OBJECTIVE: To study and compare the clinical and electroencephalography (EEG) features in children with benign occipital epilepsy (BOE) of Gastaut and Panayiotopoulos types. METHODS: The clinical data of 23 children with BOE (16 Gastaut type and 7 Panayiotopoulos type) were retrospectively studied. RESULTS: The mean age of onset in the Panayiotopoulos and Gastaut groups were 4.5 and 9.1 years, respectively. The children in the Panayiotopoulos group were characterized by ictal vomiting, frequent deviation of eyes and head, frequent nocturnal seizures, and secondary generalized seizures with longer duration but less frequency. By comparison, the children in the Gastaut group were characterized by visual symptoms as ictal events, higher seizure frequency, shorter seizure duration and more frequent diurnal seizures. The EEG showed that the majority of both groups had occipital spike-wave discharges when the eyes were opened. Eleven children in the Panayiotopoulos group and all of 7 children in the Gastaut group received antiepileptic mono-drug therapy. All of the 11 children in the Panayiotopoulos group responded to the therapy, but 2 cases in the Gastaut group did not respond and 2 cases had subtle cognitive deficits. CONCLUSIONS: There are differences in the age of onset, clinical symptoms, seizure frequency and duration, and therapeutic responses between children with Panayiotopoulos and Gastaut type BOE.