Seizures and Epilepsy: Panayiotopoulos Syndrome

Panayiotopoulos syndrome is a self-limiting epilepsy with an onset in early childhood that is characterized by focal autonomic seizures that can be prolonged (i.e. autonomic status epilepticus) and/or frequent in some patients. Seizures occur between 1y- 14y (peak 3y-6y) and usually resolve by 11y-13y with both sexes affected equally. Development, cognition, and the background EEG remain normal.

The EEG commonly shows high amplitude focal occipital spikes that may be activated by sleep or eye closure. EEG abnormalities are enhanced by sleep deprivation and may be bilaterally synchronous. Ictal patterns are unilateral, often with a posterior onset, rhythmically slow (theta or delta) activity intermixed with small spikes. Interictally, multifocal high voltage repetitive spikes or sharp and slow- waves are seen in 90% of patients, with varying focal areas on sequential EEGs. Abnormalities in the posterior regions is most common, with occipital spikes seen on EEG in 60% of patients, however these can be seen in all regions.