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Clinical Manifestations in Children with Occipital Spike‐Wave Paroxysms
Author(s) -
Talwar Dinesh,
Rask Cynthia A.,
Torres Fernando
Publication year - 1992
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1992.tb02345.x
Subject(s) - electroencephalography , migraine , medicine , abnormality , etiology , epilepsy , ictal , anesthesia , partial seizures , pediatrics , psychiatry
Summary: The pattern of occipital‐posterotemporal spike‐wave paroxysms (O‐PT SWPs), is a distinctive EEG abnormality observed primarily with occipital epilepsy of childhood and basilar artery migraine. We studied EEG and clinical features in 30 children and young adults with this EEG pattern. Prolonged and brief O‐PT SWPs were observed. Prolonged discharges (>6 s) were observed only in children with seizures (p < 0.001), and brief discharges (1–6 s) were observed immediately after eye closure. Generalized SWPs (11 patients, 37%) and background abnormalities (17 patients, 57%) were common. Photic activation of O‐PT SWPs was not observed. Twenty‐four patients (80%) manifested paroxysmal phenomena‐seizures (20 patients, 67%) and migraine (12 patients, 40%, 4 alone and 8 with seizures). Fifteen patients (75%) had partial seizures, and 5 (25%) had absence seizures. In 7 patients with partial seizures, an etiology was evident. Neurologic examination was more often abnormal in patients with secondary partial seizures than in those with idiopathic partial seizures (p < 0.05) and absence seizures. Conversely, migraine was more often associated with idiopathic partial seizures than with secondary partial seizures (p < 0.05) and absence seizures. Six children (20%) had no paroxysmal events. Generalized SWPs were uncommon in patients with idiopathic partial seizures. We conclude that 0‐PT SWPs is a nonspecific epileptiform abnormality that may occur in children with (a) idiopathic partial, (b) symptomatic partial, and (c) absence epilepsies, but it may also occur in patients with no evidence of seizures.