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Epileptic Disorders

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Investigation of paediatric occipital epilepsy using stereo-EEG reveals a better surgical outcome than in adults, especially when the supracalcarine area is affected Volume 20, numéro 5, October 2018

TEST YOURSELF

(1) What are the most frequent symptoms in paediatric occipital epilepsy?

(2) Can infantile spasms be observed in lesional occipital epilepsy in children?

(3) Can surgery be performed for children with refractory occipital epilepsy?

 

 

 

 

 

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Answers

(1) Oculomotor symptoms and head deviation are the most frequent ictal motor manifestations, considering that subjective initial visual symptoms are often impossible to obtain in the paediatric population because of young age or intellectual disability. Objective visual symptoms should be recorded during video-EEG monitoring in order to guide the clinician towards the correct epileptic zone.

(2) Infantile spasms can be triggered by any type of lesion, even occipital lesions. Even a lesion far from the motor and premotor cortex can be responsible for infantile spasms. These seizures are more related to age than type or topography of the lesion.

(3) Epilepsy surgery can be a very effective treatment for these patients, to cure seizures, especially when the epileptic zone is supracalcarine, leading to more than 80% seizure freedom. Post-surgical outcome is better than in the adult population and should encourage early surgery when possible. However, the benefits should always be weighed against the risk of new or aggravated visual field deficits.

 

 

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