Panayiotopoulos Syndrome

Background

• Also known as early onset occipital epilepsy
• Common childhood epilepsy syndrome with partial seizures (1 in 8000 children)
• Most common in 2-10 years old, with a maximum around 5 years old

Clinic

• Autonomic dysfunction
  • Pale
  • Complains of feeling sick and may vomit
  • Sweating
  • Drooling
  • Pupil dilatation or miosis
  • Tachy- or bradycardia
• Eye deviation
• Sometimes tonic-clonic movements
• Headache after the seizure
• More than half of the seizures will occur in sleep, particularly in the first hour after falling asleep.

EEG

• Spikes in one or both occipital lobes.
• Sometimes centro-temporal spikes.
• Fixation off sensitivity may be seen: The Spikes are seen when the child’s eyes are closed or if they are not fixating on an object. With eyes opened or fixated, the spikes disappear
• If the EEG done during awake is normal, an EEG during sleep is recommended

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Panayiotopoulos Syndrome in a 5 year old girl (source)

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