Panayiotopoulos syndrome: a clinico-electroencephalographic presentation of three cases from Nigeria

Panayiotopoulos syndrome (PS) is a common benign, childhood, focal, seizure susceptibility syndrome presenting with mainly focal aware or focal impaired awareness autonomic seizures and autonomic status epilepticus that is under diagnosed in our locality. Increased awareness through reporting will aid diagnosis, reduce misdiagnosis and prevent aggressive and deleterious interventions. The classic clinical and electroencephalographic (EEG) features of three cases are described and the literature reviewed. The aim is to underscore the presence in our locality of this remarkably benign epileptic syndrome that must be differentiated from febrile seizures, encephalopathy, migraine or cardiogenic syncope.

Download Full-text

Atypical Evolutions of Idiopathic Focal Epilepsies in Childhood

Journal of Pediatric Epilepsy ◽

10.1055/s-0036-1584671 ◽

2016 ◽

Vol 05 (03) ◽

pp. 122-132

Author(s):

Roberto Caraballo ◽

Santiago Flesler ◽

Natalio Fejerman

Keyword(s):

Status Epilepticus ◽

Focal Epilepsy ◽

Childhood Epilepsy ◽

Significant Percentage ◽

Epileptic Encephalopathies ◽

Atypical Features ◽

Eeg Abnormalities ◽

Number Of Patients ◽

Panayiotopoulos Syndrome ◽

Eeg Features

Clinical and electroencephalographic (EEG) features of the three well-defined idiopathic focal epilepsies in childhood (IFEC)—benign childhood epilepsy with centrotemporal spikes (BCECTS), Panayiotopoulos syndrome, and the Gastaut type of idiopathic occipital epilepsy of childhood (IOEC-G)—have been clearly described and reported. It is also known that a significant percentage of children with IFEC present what were named atypical features in seizures and EEG abnormalities. We are studying here the small number of patients with IFEC who not only present atypical features, but also evolve into the spectrum of epileptic encephalopathies related with continuous spike-and-wave during sleep (CSWSS) or electrical status epilepticus during sleep (ESES), which includes atypical benign focal epilepsy of childhood, status of BCECTS, Landau-Kleffner syndrome, and CSWSS or ESES syndrome. We also emphasize that some patients with these encephalopathic course of IFEC present a mix or a sequence in time of the four mentioned subsyndromes.

Download Full-text

Early Onset Benign Occipital Epilepsy (Panayiotopoulos syndrome): a case Report & Literature Review

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v1i1.22945 ◽

2015 ◽

Vol 1 (1) ◽

pp. 27-30

Author(s):

Md Enayet Hussain ◽

Rajib Nayan Chowdhury ◽

Md Nahidul Islam ◽

AFM Al Masum Khan ◽

Md Ferdous Miah

Keyword(s):

Case Report ◽

Status Epilepticus ◽

Literature Review ◽

Febrile Seizures ◽

Great Variability ◽

Epilepsy Syndrome ◽

Childhood Epilepsy ◽

High Prevalence ◽

Occipital Spikes ◽

Panayiotopoulos Syndrome

Panayiotopoulos syndrome is a type of benign childhood epilepsy syndrome characterized by episodic autonomic and mainly emetic symptoms. It predominantly affects children of 3-6 years of age (13% of those with one or more non-febrile seizures). EEG shows great variability, with occipital, extra-occipital spikes or brief generalised discharges alone or in combination; it may also be consistently normal. Despite the high prevalence of autonomic status epilepticus, the prognosis of Panayiotopoulos syndrome is usually excellent and most do not require anti epileptic medications. Remission usually occurs within 1-2 years from onset. One third have a single seizure but 5-10% may have more than 10 seizures or a more prolonged course. We present a 5 year old boy with this condition, who presented with episodes of severe vomiting, deviation of eyes, focal seizure, altered sensorium, characteristic EEG in the form of multiple occipital spikes and normal neuroimaging studies.J. Natl Inst. Neurosci Bangladesh 2015;1(1):27-30

Download Full-text

Autonomic seizures and autonomic status epilepticus in early onset benign childhood occipital epilepsy (Panayiotopoulos syndrome)

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2006000500004 ◽

2006 ◽

Vol 64 (3b) ◽

pp. 723-726 ◽

Cited By ~ 4

Author(s):

Gloria Maria Almeida Souza Tedrus ◽

Lineu Corrêa Fonseca

Keyword(s):

Status Epilepticus ◽

Early Onset ◽

Brain Lesions ◽

Motor Symptoms ◽

Autonomic Symptoms ◽

Visual Symptoms ◽

Occipital Spikes ◽

Panayiotopoulos Syndrome ◽

Eeg Features ◽

Spike Wave

To study clinical and EEG features of children with ictal vomiting and no underlying brain lesions (Panayiotopoulos syndrome). The subjects were 36 children aged 2-13 years. The onset of seizures occurred between 1 and 5 years of age. Fourteen children (38.8%) had a single seizure. Fourteen children (38.8%) had autonomic status epilepticus. Impairment of consciousness was reported in 30 (83.3%) children, eye deviation in 10 (27.7%) other autonomic symptoms and head deviation in 9, generalization in 8, visual symptoms in one child, and, speech arrest or hemifacial motor symptoms in 8 cases. The EEG showed occipital spikes or spike-wave complexes in 27 (75.0%) children, blocked by opening of the eyes in 8 (22.2%) cases. Nine patients (25%) also had rolandic spikes and 3 had extraoccipital spikes. Six (16.6%) patients had normal EEG. No clinical differences were observed between patients having occipital or extraoccipital spikes. In children only with autonomic seizures, the spikes are predominantly occipital but blockage by opening of the eyes is a less frequent feature. In some children there is an overlapping of different focal childhood idiopathic syndromes.

Download Full-text

Nonconvulsive status epilepticus associated with Alzheimer’s disease mimicking symptomatic focal epilepsy following the resection of a frontal parasagittal meningioma

Surgical Neurology International ◽

10.25259/sni_709_2020 ◽

2020 ◽

Vol 11 ◽

pp. 469

Author(s):

Keisuke Abe ◽

Nobutaka Mukae ◽

Takato Morioka ◽

Yuhei Sangatsuda ◽

Ayumi Sakata ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Status Epilepticus ◽

Focal Epilepsy ◽

Nonconvulsive Status Epilepticus ◽

Histopathological Diagnosis ◽

Epileptogenic Lesion ◽

Consciousness Disorder ◽

Impaired Awareness ◽

The Right

Background: Epilepsies are frequent in patients with Alzheimer’s disease (AD); however, epilepsies in AD can easily go unrecognized because they usually present as focal impaired awareness seizures or nonconvulsive status epilepticus (NCSE) and can overlap with other symptoms of AD. Case Description: We performed an epilepsy surgery in a 69-year-old woman with progressive cognitive impairment and consciousness disorder, who was diagnosed with focal NCSE related to the resected meningioma in the right frontal parasagittal region. Intraoperative electrocorticography revealed localized periodic paroxysmal discharges with beta and gamma activities in the neighboring cortex where the meningioma existed. The histopathological diagnosis of AD was first made from the resected epileptogenic cortex. Conclusion: Even when there is a suspected epileptogenic lesion that could cause focal NCSE, AD should be ruled out in elderly patients with progressive cognitive decline.

Download Full-text

Pediatric Seizures and Status Epilepticus

10.2310/em.4406 ◽

2020 ◽

Author(s):

Lindsey Retterath ◽

Dale Woolridge

Keyword(s):

Status Epilepticus ◽

Pediatric Patients ◽

Febrile Seizures ◽

Pediatric Emergency ◽

Initial Management ◽

Symptomatic Seizures ◽

Algorithmic Approaches ◽

Work Up ◽

Acute Symptomatic Seizures ◽

Management Work

Seizures represent a common neurologic complaint among pediatric patients in the emergency department (ED). They can be classified as generalized or focal. In terms of etiology, seizures are most basically broken down into “acute symptomatic” seizures, which are due to another primary medical cause, and unprovoked seizures which occur as a primary pathology. Febrile seizures are the most common types of seizures in children, which themselves can be simple or complex. The most concerning seizures are those which associate with meningismus, encephalitis, metabolic derangements, intracranial mass, and, of course those which progress to status epilepticus. Significantly, it is appropriate and even critical to assume status epilepticus and intervene accordingly whenever a child arrives to the ED seizing for an unspecified period of time. This review covers the initial evaluation, resuscitation, management, work-up, and disposition of pediatric patients who present to the emergency room with seizures. Figures in this chapter illustrate stepwise and algorithmic approaches to initial management, expanded differential, systematic diagnostic approach, and disposition for pediatric patients presenting with seizures and status epilepticus. Tables list important physical exam components for evaluating children with seizures, classifications of seizures, common seizure look-alikes in children, features of febrile seizures, etiologies of pediatric seizures. This review contains 5 figures, 11 tables, and 22 references. Key Words: pediatric seizures, febrile seizures, pediatric neurologic emergencies, pediatric emergency medicine, status epilepticus

Download Full-text

Status epilepticus during correction of hyponatremia in a patient with Alzheimer’s disease: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x20915416 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2091541

Author(s):

Ken Ichioka ◽

Nobuhiro Akuzawa ◽

Akio Takahashi

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Case Report ◽

Status Epilepticus ◽

Synaptic Cleft ◽

Sharp Waves ◽

Old Japanese ◽

Impaired Awareness ◽

Clonic Seizures ◽

The Right

An 83-year-old Japanese man with Alzheimer’s disease was admitted to our hospital for treatment of hyponatremia resulting from water intoxication. During hospitalization, the patient developed focal impaired awareness seizures, focal to bilateral tonic-clonic seizures, and subsequent status epilepticus. Electroencephalogram during focal impaired awareness seizures showed rhythmic 5–9 Hz theta activity in the right frontotemporal region. Electroencephalogram during focal to bilateral tonic-clonic seizures showed bilateral polyspikes. Electroencephalogram during an interseizure period revealed sharp waves in the right frontal region. Continuous intravenous administration of midazolam was the only effective treatment for status epilepticus. The patient died of aspiration pneumonia on day 58. Hyponatremia-associated status epilepticus is rare; in the present case, multifocal epileptogenicity resulting from Alzheimer’s disease and hyponatremia-associated elevation of glutamate levels in the synaptic cleft may have contributed to the onset of focal to bilateral tonic-clonic seizures with subsequent status epilepticus.

Download Full-text