title: Epilepsy classification and additional definitions in occipital lobe epilepsy.
abstract: OBJECTIVE
  To evaluate epileptic children with occipital lobe epilepsy (OLE) in the light of the characteristics of Panayiotopoulos syndrome and late-onset occipital lobe epilepsy of Gastaut (OLE-G).
  
  
  METHODS
  Patients were categorized into six groups: primary OLE with autonomic symptoms (Panayiotopoulos syndrome), primary OLE with visual symptoms (OLE-G), secondary OLE with autonomic symptoms (P-type sOLE), secondary OLE with visual symptoms (G-type sOLE), and non-categorized primary OLE and non-categorized secondary OLE according to characteristic ictal symptoms of both Panayiotopoulos syndrome and OLE-G, as well as aetiology (primary or secondary). Patients were compared with regards to seizure symptoms, aetiology, cranial imaging, EEG, treatment and outcome.
  
  
  RESULTS
  Of 108 patients with OLE (6.4±3.9 years of age), 60 patients constituted primary groups (32 with Panayiotopoulos syndrome, 11 with OLE-G, and 17 with non-categorized primary OLE); the other 48 patients constituted secondary groups (eight with P-type sOLE, three with G-type sOLE, and 37 with non-categorized sOLE). Epileptiform activity was restricted to the occipital area in half of the patients. Generalized epileptiform activity was observed in three patients, including a patient with Panayiotopoulos syndrome (PS). Only one patient had refractory epilepsy in the primary groups while such patients made up 29% in the secondary groups.
  
  
  CONCLUSIONS
  In OLE, typical autonomic or visual ictal symptoms of Panayiotopoulos syndrome and OLE-G do not necessarily indicate primary (i.e. genetic or idiopathic) aetiology. Moreover, primary OLE may not present with these symptoms. Since there are many patients with OLE who do not exhibit the characteristics of Panayiotopoulos syndrome or OLE-G, additional definitions and terminology appear to be necessary to differentiate between such patients in both clinical practice and studies.
authors: Ordu University, Faculty of Medicine, Department of Pediatrics, Child Neurology.
authors: Kutluhan
authors: K
authors: Yilmaz
authors: Ministery of Health, Goztepe Teaching and Research Hospital-Istanbul Medeniyet University, Department of Pediatrics, Child Neurology, Turkey.
authors: Elif Yüksel
authors: EY
authors: Karatoprak
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000145:classification* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D009778:Occipital Lobe / Q000503:physiopathology*
keywords: Panayiotopoulos syndrome; children; epilepsy classification; epilepsy syndrome; occipital epilepsy; occipital lobe epilepsy of Gastaut