Panayiotopoulos Syndrome

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  • 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


  • 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.


  • 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

Panayiotopoulos Syndrome in a 5 year old girl (source)

Panayiotopoulos Syndrome in a 5 year old girl (source) EEGpedia.png