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Occipital paroxysms in four children with epileptic seizures (EEG)

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Left top and bottom: EEG of two girls with Panayiotopoulos syndrome. Right top: EEG of a boy with frequent, brief visual seizures of elementary visual hallucinations and, occasionally, blindness. Right bottom: EEG a 15-year-old boy with symptomatic occipital lobe epilepsy. In routine EEG, high-amplitude, continuous occipital sharp and slow wave complexes (occipital paroxysms) occurred immediately after closing of the eyes, lasting as long as the eyes were closed. The EEG normalized immediately after opening the eyes and continued as long as the eyes were open, though some breaks in occipital spikes occurred. The activation of the occipital paroxysms was due to the elimination of central vision and fixation (left of the vertical bar, symbol of eyes with glasses). Occipital spikes were inhibited by fixation (right of the vertical bar, symbol of eyes without glasses). (Used with permission: Panayiotopoulos CP. Inhibitory effect of central vision on occipital lobe seizures. Neurology 1981;31:330-3.)