DİLEK ÖZKUL, HANDE GAZETECİ TEKİN
The Journal of Pediatric Research - 2025;12(2):96-101
Aim Childhood epilepsy with occipital discharges encompasses various subtypes, including childhood occipital visual epilepsy (COVE), self-limited epilepsy with autonomic seizures (SeLEAS), photosensitive occipital lobe epilepsy, symptomatic epilepsy, and unclassified cases. The primary aim of this study was to analyze the clinical characteristics of pediatric epilepsy patients with occipital discharges based on their etiological classification and to compare any differences between these subgroups. Additionally, this study sought to identify prognostic factors by comparing patients who achieved remission within 36 months (Group 1) with those who did not respond within the same period (Group 2). Materials and Methods This study included 84 children diagnosed with occipital discharge-related epilepsy. A comprehensive review of their medical records was conducted, assessing their demographic data, ictal symptoms, neurological examination findings, electroencephalography and magnetic resonance imaging results, family history, febrile seizures, and treatment responses. RESULTS Of the total cohort, 32% (n=27) were classified as Group 1, while 68% (n=57) were in Group 2. Structural brain abnormalities were significantly more prevalent in Group 2. The age at diagnosis was significantly younger in Group 2 compared to Group 1 (p=0.003), and the rate of intellectual disability was higher in Group 2 (p=0.05). The presence of systemic diseases and the use of multiple anti-epileptic drugs were significantly more frequent in Group 2 (p=0.021, p=0.018). The duration of epilepsy follow-up was notably longer in Group 2 (p<0.001). COVE and SeLEAS were more commonly found in the early remission group (p=0.012, p=0.034), while no cases of symptomatic occipital epilepsy achieved remission within the first 36 months (p=0.001). CONCLUSION The majority of children with occipital epilepsy did not achieve remission within 36 months. Younger age at onset and the presence of intellectual disability were associated with longer periods of non-remission. COVE and SeLEAS were more likely to achieve early remission, whereas symptomatic occipital epilepsies showed no remission within the first 36 months. These findings underline the importance of early diagnosis and highlight the potential impact of structural brain abnormalities and cognitive impairments on the prognosis of childhood occipital epilepsy.
