OCCIPITOTEMPORAL SEIZURES WITH ICTUS EMETICUS INDUCED BY INTERMITTENTPHOTIC-STIMULATION

We recorded occipitotemporal seizures induced by intermittent photic s timulation in three children with brain injuries, aged 10 to 13 years. All had a history of seizures and showed occipital spikes on EEG, but were seizure free and were not being treated at the time of investiga tion. In all, photic stimulation induced seizures in the right occipit al lobe. They were followed by clinical and EEG signs suggesting infra sylvian spreading to ipsilateral mesiotemporal limbic structures and b y vomiting, appearing at late stages of the attacks. Seizure spread wa s very slow in two patients in whom attacks lasted 16 and 25 minutes. Patients with occipital epileptiform abnormalities presenting with ict al vomiting are often diagnosed as having vague migraine-epilepsy synd romes. We conclude that vomiting can be a late ictal phenomenon result ing from temporal lobe spread of seizures originating in the occipital lobe.