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Title: Occipital epilepsies: identification of specific and newly recognized syndromes.
Austin Authors: Taylor, Isabella;Scheffer, Ingrid E ;Berkovic, Samuel F 
Affiliation: Epilepsy Research Institute, University of Melbourne, Austin and Repatriation Medical Centre, Heidelberg West, Victoria, Australia
Issue Date: 1-Apr-2003
Publication information: Brain : A Journal of Neurology; 126(Pt 4): 753-69
Abstract: Occipital epilepsies often elude diagnosis as they frequently masquerade as other seizure syndromes. Visual hallucinations are the key clinical symptoms indicating an occipital focus, but may be difficult to elicit on history, especially from children, and are not always present. When visual symptoms are not prominent, the seizure semiology and scalp EEG may lead the clinician away from considering an occipital focus, as they often reflect seizure propagation rather than seizure origin. Clinical and neuroimaging advances have led to the recognition of many new occipital epilepsy syndromes, which generally present in childhood or adolescence. Major groups include malformations of cortical development [focal cortical dysplasia, periventricular heterotopia (PVH), subcortical band heterotopia (SBH), polymicrogyria], vascular (including epilepsy with bilateral occipital calcifications often associated with coeliac disease), metabolic and the emerging idiopathic occipital epilepsies. The idiopathic occipital epilepsies now comprise three identifiable electroclinical syndromes of childhood and adolescence, the biological inter-relationships and overlap with idiopathic generalized epilepsies of which are discussed here. We emphasize the clues to recognition of specific occipital epilepsies, some of which now have specific treatments. Where medical therapy is ineffective, occipital corticectomy should be considered. Emerging evidence suggests that some syndromes have a good surgical outcome, and the consequences to visual function may be less severe than anticipated.
Gov't Doc #: 12615636
Journal: Brain
Type: Journal Article
Subjects: Cerebral Cortex.abnormalities
Diagnosis, Differential
Magnetic Resonance Imaging.methods
Migraine Disorders.diagnosis
Occipital Lobe
Tomography, X-Ray Computed.methods
Appears in Collections:Journal articles

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