Clinical dissection of childhood occipital epilepsy of Gastaut and prognostic implication.
OBJECTIVE
Our aim was to describe the clinical and electrical features and the long-term evolution of childhood occipital epilepsy of Gastaut (COE-G) in a cohort of patients and to compare long-term prognosis between patients with and without other epileptic syndromes.


METHODS
This was a retrospective analysis of the long-term outcome of epilepsy in 129 patients with COE-G who were referred to 23 Italian epilepsy centres and one in Austria between 1991 and 2004. Patients were evaluated clinically and with electroencephalograms for 10.1-23.0 years. The following clinical characteristics were evaluated: gender, patient age at seizure onset, history of febrile seizures and migraine, family history of epilepsy, duration and seizure manifestations, circadian distribution and frequency of seizures, history of medications including the number of drugs, therapeutic response and final outcome.


RESULTS
Visual hallucinations were the first symptom in 62% and the only manifestation in 38.8% of patients. Patients were subdivided into two groups: group A with isolated COE-G; group B with other epileptic syndromes associated with COE-G. The most significant (P < 0.05) difference concerned antiepileptic therapy: in group A, 45 children responded to monotherapy; in group B only 15 children responded to monotherapy. At the end of follow-up, the percentage of seizure-free patients was significantly higher in group A than in group B.


CONCLUSIONS
Childhood occipital epilepsy of Gastaut has an overall favourable prognosis and a good response to antiepileptic therapy with resolution of seizures and of electroencephalogram abnormalities. The association of typical COE-G symptoms with other types of seizure could be related to a poor epilepsy outcome.
Department of Paediatrics, University of Perugia, Perugia, Italy.
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A
Verrotti
Department of Paediatrics, University of Perugia, Perugia, Italy.
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D
Laino
Department of Paediatrics, University of Perugia, Perugia, Italy.
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VE
Rinaldi
Paediatric Neurology Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy.
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A
Suppiej
Paediatric Neuropsychiatric Division, Spedali Civili, Brescia, Italy.
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L
Giordano
Paediatric Neurology Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy.
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I
Toldo
Unit of Child Neuropsychiatry, Department of Basic Medical Sciences, Neuroscience and Sense Organs, 'Aldo Moro' University of Bari, Bari, Italy.
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L
Margari
NESMOS Department, Chair of Paediatrics, Paediatric Headache Centre, Paediatric Sleep Centre and Child Neurology, Faculty of Medicine and Psychology, Sant'Andrea Hospital, 'Sapienza University', Roma, Italy.
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P
Parisi
Section of Child Neuropsychiatry, Department of Paediatrics, University of Catania, Catania, Italy.
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R
Rizzo
Departement of Paediatrics, University of Chieti, Chieti, Italy.|Department of Paediatric Neuroscience, Foundation IRCCS Neurological Institute 'C. Besta', Milano, Italy.
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Matricardi
Neurology Unit, 'Bambino Gesù' Children's Hospital, IRCCS, Roma, Italy.
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R
Cusmai
Paediatric Neurology-Immunology and Endocrinology Unit, University of Siena, Siena, Italy.
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S
Grosso
Paediatric Unit, San Paolo Hospital, Savona, Italy.
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R
Gaggero
Child Neuropsychiatry Unit, Polytechnic University of the Marche, Ancona, Italy.
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N
Zamponi
Unit of Paediatrics and Paediatric Emergency 'Costanza Gravina', University-Hospital 'Vittorio Emanuele, Policlinic', University of Catania, Catania, Italy.
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http://orcid.org/0000-0002-5600-9560
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Pavone
Department of Child Neuropsychiatry, Epilepsy Centre, C. Poma Hospital, Mantova, Italy.
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G
Capovilla
Department of Paediatrics, Medical University Innsbruck, Innsbruck, Austria.
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M
Rauchenzauner
Paediatric Neurology, Department of Neurosciences, Tor Vergata University of Rome, Roma, Italy.
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C
Cerminara
IRCCS 'NEUROMED', Pozzilli, Italy.
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G
Di Gennaro
Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Centre for Childhood Headache, Second University of Naples, Napoli, Italy.
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M
Esposito
Paediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 'G. Gaslini' Institute, Genova, Italy.
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P
Striano
Department of Paediatrics, Pavia University Foundation, IRCCS Policlinico San Matteo, Pavia, Italy.
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S
Savasta
Child and Adolescent Neuropsychiatry, Medical School, University of Salerno, Salerno, Italy.
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G
Coppola
Child Neuropsychiatry Unit, Polytechnic University of the Marche, Ancona, Italy.
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S
Siliquini
Unit of Child Neuropsychiatry, Department of Basic Medical Sciences, Neuroscience and Sense Organs, 'Aldo Moro' University of Bari, Bari, Italy.
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F
Operto
Neurology Unit, Department of Neuroscience, 'Sant'Anna' Hospital, Como, Italy.
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V
Belcastro
Department of Paediatric Neuroscience, Foundation IRCCS Neurological Institute 'C. Besta', Milano, Italy.
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F
Ragona
Department of Paediatrics, Pavia University Foundation, IRCCS Policlinico San Matteo, Pavia, Italy.
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GL
Marseglia
Child Neurology, Chair of Paediatrics, II Faculty of Medicine, University of Rome, Roma, Italy.
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Spalice
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000494:pharmacology*; D001317:Austria; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007223:Infant; D065768:Lennox Gastaut Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D009778:Occipital Lobe / Q000503:physiopathology*; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
D000927:Anticonvulsants
EEG; antiepileptic therapy; focal epilepsy; generalized epilepsy; idiopathic occipital epilepsy; outcome