Panayiotopoulos syndrome: a prospecitve study of 14 patients

Panayiotopoulos syndrome is a relatively frequent and benign autonomic childhood epileptic disorder with significant clinical, pathophysiological and management implications. It affects otherwise normal children with the onset at 3-6 years. It is characterized by seizures with predominantly autonomic symptoms and mainly ictal vomiting, sometimes followed by impairment of consciousness. Electroencephalography (EEG) shows shifting and/or multiple foci, often with occipital dominance. Despite characteristic clinical and EEG manifestations, Panayiotopoulos syndrome is often confused with acute non-epileptic disorders such as encephalitis, gastroenterocolitis, syncope, migraine, metabolic diseases, or cyclic vomiting syndrome. Fourteen children with electroclinical criteria of Panayiotopoulos syndrome were included in this 7-year prospective study. The study focused on the main clinical and EEG features of this epilepsy. Children were followed-up clinically and with awake and sleep EEG between 2004 and 2010. The mean age at first seizure was 3.5 years and boys predominated (64%). In total 45 seizures were analyzed. Autonomic manifestations were the most common ictal event. Vomiting was present in all seizures, ictal deviation of the eyes and progression to impairment of consciousness were also frequent. Eight (57%) children had a single seizure, while four boys (29%) had more than 5 attacks despite antiepileptic therapy. All seizures occurred during sleep and more than half ended with hemiconvulsions (33%) or generalized tonicclonic convulsions (36%).

Category: Original scientific paper
Volume: Vol. 49, No 3, july - september 2005
Authors: M. Čačić Hribljan
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