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Ann Child Neurol > Volume 25(3); 2017 > Article
Journal of the Korean Child Neurology Society 2017;25(3):121-126.
DOI: https://doi.org/10.26815/jkcns.2017.25.3.121    Published online September 30, 2017.
Childhood Idiopathic Occipital Lobe Epilepsy: Clinical Characteristics and Prognostic Factors.
Ji Yoon Kwon, Gun Ha Kim, So Hee Eun, Baik Lin Eun, Jung Hye Byeon
Department of Pediatrics, Korea University College of Medicine, Seoul, Korea. byeonagnes@naver.com
Abstract
PURPOSE
Among syndromes of idiopathic occipital lobe epilepsy there are Panayiotopoulos syndrome (PS) and idiopathic childhood occipital epilepsy of Gastaut (ICOE-G). However, the classification of epilepsy syndrome is difficult to diagnose at the first seizure because of varying characteristics. We analyzed the different clinical characteristics and prognostic factors of idiopathic occipital lobe epilepsy. METHODS: Forty-three patients who had at least two unprovoked seizures, no abnormalities on magnetic resonance imaging, no known etiology of seizure, and mainly occipital spikes on electroencephalography were retrospectively enrolled at the Korea University Medical Center. A good prognosis was defined as being seizure-free and taking two or less drugs for 1 year. RESULTS: Among all patients, the proportion of PS was 44.2%, ICOE-G was 7.0% and unclassified group was 48.8%. The age at seizure onset was 4.5±2.6 years (mean±SD) in the PS group, and 8.3±2.1 years in the ICOE-G group. The follow-up duration was 10.8±6.0 years. The percentage that the initial diagnosis had not been changed was 66.7% in the PS group and 100% in the ICOE-G group. Among other related symptoms only emesis (P<0.001) and visual symptoms (P=0.007) had varying characteristics between the PS and ICOE-G groups. Patients with PS had a better prognosis than those with ICOE-G or unclassified group (odds ratio [OR]=58.8). Patients with 1 more autonomic symptoms had a worse prognosis (OR=3.8). CONCLUSION: This study showed that only symptoms of emesis and visual symptoms can differentiate between PS and ICOE-G. More autonomic symptoms were associated with worse prognosis in childhood occipital lobe epilepsy.
Key Words: Idiopathic occipital epilepsy, Prognosis, Panayiotopoulos syndrome


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