Benign childhood occipital seizures

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Abstract
Benign childhood epilepsy with centrotemporal spikes or rolandic epilepsy is well recognised,1-3 but benign childhood occipital seizures (BCOS) are not widely known.1-7 BCOS have a prevalence of 20–25% among benign childhood partial seizures,6 with two clinical forms: early onset BCOS described by Panayiotopoulos4 6 and late onset BCOS of Gastaut.5 Idiopathic photosensitive occipital seizures are also well documented.8-10 Seizures consist of autonomic and behavioural disturbances with vomiting and deviation of the eyes lasting from minutes to hours. They are mainly nocturnal and often progress to convulsions. Consciousness is usually impaired from onset or during the ictus. By definition, seizures lasting for more than half an hour are status epilepticus. In one third of these children, the phase of deviation of the eyes with vomiting and impairment of consciousness is prolonged for more than 30 minutes (partial status epilepticus) and usually ends with generalised convulsions. A typical case is of a child who wakes up from sleep agitated, vomiting, eyes deviated to one side, and who may or may not be able to communicate for minutes to hours before hemiconvulsions or generalised convulsions begin. Onset is between 1–12 years, peak is at 5 years, and remission occurs within 1–2 years from onset. In one third of the patients, seizures or even partial status epilepticus are single events in the child’s life. The mean total of seizures is three and the maximum is 15.7 Early onset BCOS are entirely benign. Only four out of 113 children with early onset BCOS developed rolandic seizures, and only one continued with infrequent generalised convulsions.7 A grave neurological condition may …