Clinical and electroencephalographic findings in early and late onset benign childhood epilepsy with occipital paroxysms

Twenty-six patients were studied who had the clinical and electroencephalog raphic features of benign childhood epilepsy with occipital paroxysms (BCEO P) as defined by the Commission of the International League Against Epileps y (ILAE). Twelve patients were characterized as having early-onset benign c hildhood occipital seizures (EBOS) susceptible syndrome, as described by Pa nayiotopoulos, and 14 patients had late onset childhood idiopathic occipita l seizures (LOS). Patients with symptomatic epilepsy and whose EEGs exhibit ed occipital spikes were excluded. The age of onset of the EBOS group range d from 2.6 to 9.4 years (mean: 4.9 +/- 1.7 years), which was significantly younger than the LOS group (range: 4-12 years, mean:8.4 +/- 2.5 years). Bot h sexes were equally affected. The patients in the EBOS group had less freq uent and longer seizures, ictal vomiting, more frequent deviation of the ey es, adversive seizures and more frequent nocturnal and secondary generalize d seizures (P < 0.05). By comparison, patients in the LOS group had a highe r incidence of seizures, shorter duration of seizures and more frequent diu rnal onset (P < 0.01); also, although not statistically significant, the LO S group had more frequent visual hallucinations and headaches. The EEG topo graphy in both groups showed at either side of occipital area typical parox ysms that were unilateral or bilaterally synchronous. Neither group had dip oles according to scalp voltage mapping. The clinical prognoses were favora ble for both groups. To distinguish EBOS from LOS, detailed description of the age of onset, motor symptoms, visual symptoms, presence of eye deviatio n and diurnal or nocturnal occurrence are essential. (C) 2001 Elsevier Scie nce B.V. All rights reserved.