Background:

Pediatric occipital epileptiform discharges occur in various clinical settings, including self-limited and treatment-resistant epilepsies. The study objective is to determine electro-clinical predictors for prognosis in children with occipital epileptiform discharges.

Methods:

205 patients with occipital epileptiform discharges were classified into seizure groups: self-limited occipital (SLO) (n = 57), including Panayiotopoulos and Gastaut syndrome; non-self-limited occipital (non-SLO) (n = 98), including various seizure etiologies; genetic-generalized (n = 18); febrile (n = 5); and no-seizure (n = 27) groups. Electro-clinical features of the SLO and non-SLO were compared, as this is of most clinical relevance.

Results:

The median age of seizure onset was 3 years (range: 0-19). Occipital epileptiform discharges with frontal/central positivity were present in both groups, but more common in the SLO than non-SLO groups; 21/57 (36.8%) and 19/98 (19.4%), respectively (P < .022). However, when occipital epileptiform discharges with tangential dipoles (P < .048) were accompanied by abnormal ictal eye movements (P < .037), they were predictive of SLO epilepsy.

Conclusions:

In our cohort, occipital epileptiform discharges with tangential dipole detected by visual analysis and abnormal ictal eye movements were predictive of SLO epilepsy.

中文翻译：

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26 年来单个中心的小儿枕骨尖峰和切向偶极子的意义

背景：

小儿枕部癫痫样放电发生在各种临床环境中，包括自限性和难治性癫痫。研究目的是确定枕部癫痫样放电儿童预后的电临床预测因子。

方法：

205 例枕部癫痫样放电患者被分为癫痫发作组：自限性枕部 (SLO) (n = 57)，包括 Panayiotopoulos 和 Gastaut 综合征；非自限性枕部 (non-SLO) (n = 98)，包括各种癫痫发作病因；遗传广义（n = 18）；发热（n = 5）；和无癫痫发作 (n = 27) 组。比较了 SLO 和非 SLO 的电临床特征，因为这具有最大的临床相关性。

结果：

癫痫发作的中位年龄为 3 岁（范围：0-19）。两组均存在额叶/中央阳性的枕部癫痫样放电，但在 SLO 组中比非 SLO 组更常见；分别为 21/57 (36.8%) 和 19/98 (19.4%) ( P < .022)。然而，当具有切向偶极子的枕部癫痫样放电 ( P < .048) 伴有异常发作期眼球运动 ( P < .037) 时，它们可预测 SLO 癫痫。

结论：

在我们的队列中，通过视觉分析检测到具有切向偶极子的枕部癫痫样放电和异常发作期眼球运动可预测 SLO 癫痫。