IDIOPATHIC REGIONAL OCCIPITAL EPILEPSY IMITATING MIGRAINE

This 24-year-old woman of normal physical and mental state had from th e age of 12 years brief seizures of visual hallucinations of multicolo red circular flashing bright lights followed by severe headache and vo miting. These were initially misdiagnosed as migraine. One year later the visual hallucinations were followed by generalized convulsions. El ectroencephalogram (EEG) consistently showed brief posterior paroxysma l fast spiking activity occurring immediately after closing of the eye s and not persisting with the eyes closed. These eye-closure related a bnormalities were totally inhibited in complete darkness and eliminati on of central vision. Intermittent photic stimulation induced time-loc ked occipital spikes. This patient is of interest because she has an u nusual form of idiopathic regional occipital epilepsy that may be misd iagnosed as migraine with aura. (C) 1997 by Elsevier Science Inc. All rights reserved.