RESUMO
Self-limited epilepsy with autonomic seizures, formerly known as benign occipital epilepsy of childhood or Panayiotopoulos syndrome is a focal epilepsy that is part of the epileptic syndromes with onset during childhood. The objective of this report is to raise awareness about its importance and describe the clinical manifestations, timely diagnosis, and treatment. A pediatric patient admitted with gastrointestinal manifestations is presented. The autonomic manifestations must be considered as part of the clinical spectrum that includes this disease and the digestive and autonomic manifestations that mask the diagnosis, sometimes even in the absence of motor seizures themselves. Electroencephalographic confirmation was performed, avoiding cataloging it in other differential diagnoses.
RESUMO
This study intended to investigate the clinical and electroencephalographic benign occipital epilepsy of childhood (BOEC) characteristics in a population sample of patients from two tertiary Brazilian hospitals. We analyzed retrospectively 4912 electroencephalograms (EEGs) records, and the included patients were submitted to a new clinical and EEG evaluation. Were included 12 (0.92 percent) patients; 4 (33.3 percent) with criteria for early BOEC; 6 (50 percent) for late form and 2 (16.7 percent) with superimposed early and late onset forms. After new investigation, 2 (16.7 percent) had normal EEG; 4 (33.3 percent) had paroxysms over the occipital region; 3 (25 percent) over the temporal posterior regions and 3 (25 percent) over the posterior regions. Sharp waves were the predominant change, occurring in 8 (66.6 percent); spike and slow wave complexes in 1 (8.3 percent) and sharp and slow wave complexes in 1 (8.3 percent). Vomiting, headache and visual hallucinations were the most common ictal manifestations, presented in 100 percent of patients with superimposed forms. Vomiting were absent in the late form and headache was present in all forms of BOEC.
Este estudo teve como objetivo investigar as características clínicas e eletrencefalográficas da epilepsia occipital benigna da infância (EOBI) em uma amostra populacional de pacientes de dois hospitais terciários brasileiros. Foram analisados retrospectivamente 4912 registros de eletrencefalograma (EEG). Os pacientes incluídos foram submetidos a nova avaliação clínica e eletrencefalográfica. Foram incluídos 12 (0,92 por cento) pacientes; 4 (33,3 por cento), com critérios para EOBI de início precoce; 6 (50 por cento) para a forma tardia e 2 (16,7 por cento), com superimposição de formas de início precoce e tardio. Após nova investigação, 2 (16,7 por cento) apresentaram EEG normal; 4 (33,3 por cento) paroxismos sobre a região occipital; 3 (25 por cento) sobre a região temporal posterior e 3 (25 por cento) sobre as regiões posteriores. Ondas agudas foram a alteração predominante, ocorrendo em 8 (66,6 por cento); complexos espícula e onda lenta em 1 (8,3 por cento) e complexos onda aguda e onda lenta em 1 (8,3 por cento). Vômitos, cefaléia e alucinações visuais foram as manifestações ictais mais comuns, estando presentes em 100 por cento dos pacientes com formas superimpostas de EOBI. Vômitos não foram relatados na forma tardia e cefaléia esteve presente em todas as formas de EOBI.