title: Paroxysmal occipital discharges suppressed by eye opening: spectrum of clinical and imaging features at a tertiary care center in India.
abstract: BACKGROUND
  Paroxysmal occipital discharges (PODs) demonstrating the phenomena of fixation-off sensitivity have classically been described in childhood epilepsies with occipital paroxysms.
  
  
  OBJECTIVE
  We attempted to delineate the demographic, clinical and imaging characteristics of patients whose interictal electroencephalograms (EEGs) showed occipital discharges with fixation-off sensitivity at our center.
  
  
  METHODS
  During the period between 2003 and 2005, patients whose interictal EEGs showed PODs were included in the study. A detailed history, clinical examination and EEG findings along with imaging characteristics were analyzed.
  
  
  RESULTS
  Of the 9,104 interictal EEGs screened during the study period, 11 patients (6 females and 5 males) aged between 5 and 17 years were identified to have PODs with fixation-off sensitivity. Five had history of generalized tonic-clonic seizures. Three patients could be classified under Panayiotopoulos syndrome; the remaining 8 (72.2%) patients had symptomatic epilepsy.
  
  
  CONCLUSIONS
  This study suggests that the phenomenon of fixation-off sensitivity is found not only in patients of idiopathic focal epilepsies, but also in a substantial number of patients of symptomatic epilepsy. The high proportion of symptomatic epilepsy with phenomenon of fixation-off sensitivity may be related to the referral pattern.
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Bhavna
authors.initials: B
authors.lastname: Kaul
authors.forename: Garima
authors.initials: G
authors.lastname: Shukla
authors.forename: Vinay
authors.initials: V
authors.lastname: Goyal
authors.forename: Achal
authors.initials: A
authors.lastname: Srivastava
authors.forename: Madhuri
authors.initials: M
authors.lastname: Behari
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis*; D005123:Eye; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D009778:Occipital Lobe / Q000503:physiopathology*; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data