Panayiotopoulos syndrome: video-EEG illustration of a typical seizure

Abstract

Panayiotopoulos syndrome (PS) is a form of idiopathic, partial epilepsy of childhood with a high prevalence rate, but with poor clinical recognition, possibly due to the characteristics of the seizure, which not infrequently lack common epileptic motor and/or sensory phenomena. Instead, autonomic symptoms such as retching and vomiting, predominate. Semiological knowledge of the seizures in PS depends mainly on parental observations, but not enough ictal-EEG data are available, possibly due to the rarity of seizures. In addition to previous knowledge regarding the occipital onset of seizures in PS, it has been recognized that other areas, mainly the frontal regions, may be involved. The present report demonstrates the video-EEG findings of a seizure in a patient with PS. Subclinical ictal EEG discharges with occipital onset precede the clinical autonomic symptoms; eye deviation which is typical of occipital involvement, appears in later sequences. These findings suggest that at least for certain seizures an occipital origin may be considered, even in seizures without the early manifestations typical of this region. (Published with videosequences).