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Benign occipital epilepsy, also known as benign focal epilepsy with occipital paroxysms, is a hereditary type of epilepsy that represents about 3 percent of all childhood epilepsy cases. There is a somewhat higher incidence in girls than in boys. This type of epilepsy can be grouped into two categories, depending on the age of the child when seizures begin.
Panayiotopoulos type begins between 15 months and 17 years. Seizures are infrequent and typically occur at night, shortly after the child falls asleep. Episodes usually last less than 10 minutes and may include vomiting and gazing toward one side, and frequently evolve to rhythmic muscle contractions on one or both sides of the body. Triggers may include turning off lights, going from lighted areas to dark ones, or from dark areas to light ones.
Gastaut type begins between the ages of 3 and 16 years and has a peak onset between ages 7 and 9. Children may experience visual hallucinations with the seizure. Headaches are common before, during, or after the seizures.
Diagnosis involves a visit with an epilepsy doctor, a patient history, neurological exam, and other clinical tests, as well as neurodiagnostic testing such as EEG and MRI. This type of epilepsy is characterized by focal seizures, meaning abnormal electrical brain activity occurs on only one side of the brain. Activity originates from the part of the brain called the occipital region (located in the back of the head). An EEG will show occipital spikes with both the eyes open and closed.
The prognosis for benign occipital epilepsy is excellent, and most children (60 percent) outgrow the seizures after two to four years in the Gastaut type. The Panayiotopoulos type is relatively benign and often doesn’t require treatment. For children who do require treatment for benign occipital epilepsy, anti-epileptic drugs may be prescribed.
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UPMC Children’s Hospital of Pittsburgh
One Children’s Hospital Way
4401 Penn Ave.
Pittsburgh, PA 15224
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