medigraphic.com
ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2021, Number 1

<< Back Next >>

An Med Asoc Med Hosp ABC 2021; 66 (1)

Panayiotopoulos syndrome. Clinical manifestations and electroencephalographic features

Alderete BJ, Islas GD, Quiroz SCV, Perera CRN

Language: Spanish
References: 20
Page: 67-71
PDF size: 258.81 Kb.


ABSTRACT

Panayiotopoulos syndrome is a benign epilepsy of childhood, commonly diagnosed between 3 and 6 years of age, characterized by autonomic manifestations, visual symptoms and/or simple focal motor attacks. The etiopathogenesis is not all clear. It has been postulated that the activation of low threshold areas of limbic structures of the brain interconnected to the autonomic nervous system. As electroencephalographic findings, high amplitude occipital and extraoccipital spikes are presented. Seizures are self-limited, with spontaneous remission one or two years after the onset of symptoms. Objective: Description of the clinical and electroencephalographic features in Panayiotopoulos syndrome. Case report: We presented an 18-month-old baby present with clonic tonic febrile seizures. At age four years old, he presented generalized pallor, nausea, vomiting, followed by cephalic and ocular version to the left, lasting three to five minutes. Neurological examination and neuroimaging were normal. Electroencephalogram showed spikes and sharp waves over both occipital regions mainly during sleep, consistent with Panayiotopoulos syndrome. Antiseizure medication with carbamazepine and levetiracetam was started. The prognosis is generally favorable. The focal electroencephalographic pattern may change over time. It is important to make an electro-clinical diagnosis to evaluate the incidence of the disease.


REFERENCES

  1. Graziosi A, Pellegrino N, Di Stefano V, Raucci U, Luchetti A, Parisi P. Misdiagnosis and pitfalls in Panayiotopoulos syndrome. Epilepsy Behavior. 2019; 98: 124-128.

  2. Oguni H, Hirano Y, Nagata S. Encephalopathy related to status epilepticus during slow sleep (ESES) as atypical evolution of Panayiotopoulos syndrome: an EEG and neuropsychological study. Epileptic Disord. 2020; 22 (1): 67-72.

  3. Panayiotopoulos syndrome [Internet]. Epilepsydiagnosis.org. 2020 [Cited 2 June 2020]. Available from: https://www.epilepsydiagnosis.org/syndrome/panayiotopoulos-videos.html.

  4. Chen H, Koubeissi M. Electroencephalography in epilepsy evaluation. Continuum (Minneap Minn). 2019; 25 (2): 431-453.

  5. Weir E, Gibbs J, Appleton R. Panayiotopoulos syndrome and benign partial epilepsy with centro-temporal spikes: a comparative incidence study. Seizure. 2018; 57: 66-69.

  6. Caraballo R, Pasteris M, Portuondo E, Fortini P. Panayiotopoulos syndrome and diffuse paroxysms as the first EEG manifestation at clinical onset: a study of nine patients. Epileptic Disord. 2015; 17 (2): 143-149.

  7. Tata G, Guveli B, Dortcan N, Cokar O, Kurucu H, Demirbilek V et al. Panayiotopoulos syndrome and symptomatic occipital lobe epilepsy of childhood: a clinical and EEG study. Epileptic Disord. 2014; 16 (2): 197-202.

  8. Michael M, Tsatsou K, Ferrie C. Panayiotopoulos syndrome: an important childhood autonomic epilepsy to be differentiated from occipital epilepsy and acute non-epileptic disorders. Brain Dev. 2010; 32 (1): 4-9.

  9. Pelak V. Visual hallucinations and higher cortical visual dysfunction. Continuum: Lifelong Learning in Neurology. 2009; 15 (4): 93-105.

  10. Parisi P, Villa M, Pelliccia A, Rollo V, Chiarelli F, Verrotti A. Panayiotopoulos syndrome: diagnosis and management. Neurol Sci. 2007; 28 (2): 72-79.

  11. Ferrie C, Caraballo R, Covanis A, Demirbilek V, Dervent A, Kivity S et al. Panayiotopoulos syndrome: a consensus view. Dev Med Child Neurol. 2006; 48 (3): 236-240.

  12. Galanopoulou A, Lado F. Classification, pathophysiology, causes, differential diagnosis of paroxysmal events. Continuum. Lifelong Learning in Neurology. 2004; 10 (4): 11-41.

  13. Oreña-Ansorena VA, Blanco-Lago R, Hedrera-Fernández A, Bonifacio M, Santoveña-González L, Quesada-Colloto P et al. Epilepsia sintomática con inicio que imita el síndrome de Panayiotopoulos: importancia de la neuroimagen. Revista de Neurología. 2020; 70 (04): 134. Available from: https://doi.org/10.33588/rn.7004.2019493.

  14. Akca KS, Elmali A, Demirbilek V, Oktem O, Yapici Z, Saltik S et al. Panayiotopoulos syndrome and Gastaut syndrome are distinct entities in terms of neuropsychological findings. Epilepsy & Behavior. 2019; 99: 106447.

  15. Saito N, Kanazawa O, Tohyama J, Akasaka N, Kamimura T, Toyabe S et al. Brain maturation-related spike localization in Panayiotopoulos syndrome: magnetoencephalographic study. Pediatr Neurol. 2008; 38 (2): 104-110.

  16. Fujiwara T. Clinical spectrum of mutations in SCN1A gene: Severe myoclonic epilepsy in infancy and related epilepsies. Epilepsy Res. 2006; 70 (Suppl. 1): S223-230.

  17. Leal AJ, Ferreira JC, Dias AI, Calado E. Origin of frontal lobe spikes in the early onset benign occipital lobe epilepsy (Panayiotopoulos syndrome). Clin Neurophysiol. 2008; 119 (9): 1985-1991.

  18. Leal A, Lopes R, Ferreira J. Origin and dynamics of epileptic activity in a symptomatic case of Panayiotopoulos syndrome: correlation with clinical manifestations. Clinical Neurophysiology. 2013; 124 (1): 20-26.

  19. Plummer C, Harvey A, Cook M. EEG source localization in focal epilepsy: Where are we now? Epilepsia. 2008; 49 (2): 201-218.

  20. Panayiotopoulos CP. Vomiting as an ictal manifestation of epileptic seizures and syndromes. J Neurol Neurosurg Psychiatry. 1988; 51 (11): 1448-1451.




2020     |     www.medigraphic.com