title: A magnetoencephalographic study of patients with Panayiotopoulos syndrome.
abstract: OBJECTIVE
  Panayiotopoulos syndrome (PS) is a newly identified type of benign childhood epilepsy characterized by ictal vomiting and eye deviation. It is usually accompanied by occipital spike discharges; however, its classification as an early-onset benign childhood occipital epilepsy is controversial. To characterize this condition further, we examined the localization of equivalent current dipoles (ECDs) of spike discharges by magnetoencephalography (MEG) in patients with PS.
  
  
  METHODS
  We studied 13 patients with a mean age at time of examination of 5 years (range, 3-14 years). MEG was measured by using a whole-head 204-channel neuromagnetometer with simultaneous EEG recordings. The estimated locations of ECDs of each peak of the spike discharges were overlaid on magnetic resonance images of the brain.
  
  
  RESULTS
  Eleven (84.6%) patients showed clustered ECDs in the areas alongside the parietooccipital sulcus (eight of 13; 61.5%) and/or the calcarine sulcus (four of 13; 30.8%). Despite Fp-O synchronization of the spike discharges in the scalp EEG of five patients, no frontal locations of ECDs were found. All five (38.5%) boys with sylvian seizures, who also showed clustered ECDs in rolandic areas, had an earlier age at onset and higher seizure frequency than did other patients. ECD orientations were regular in all but one patient, who showed irregular and dispersed ECDs alongside bilateral calcarine sulci.
  
  
  CONCLUSIONS
  Our results demonstrate localized cortical hyperexcitability in the areas alongside major cortical sulci in PS and indicate that PS is closely related to benign childhood epilepsy with centrotemporal spikes.
authors: Department of Pediatrics, Epilepsy Center, Nishi-Niigata Chuo National Hospital, 1-14-1 Masago, Niigata 950-2085, Japan. kaz@masa.go.jp
authors: Osamu
authors: O
authors: Kanazawa
authors: Jun
authors: J
authors: Tohyama
authors: Noriyuki
authors: N
authors: Akasaka
authors: Takanori
authors: T
authors: Kamimura
mesh_terms: D000293:Adolescent; D002540:Cerebral Cortex / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004569:Electroencephalography / Q000706:statistics & numerical data; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D019305:Epilepsy, Rolandic / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D015225:Magnetoencephalography / Q000706:statistics & numerical data*; D008297:Male