Occipital epilepsy, a rare condition that affects children, causes seizures originating in the occipital lobe of the brain and can lead to vision problems, headaches, and nausea. Diagnosis involves a neurological exam and EEG, and treatment typically involves drug therapy or surgery.
Occipital epilepsy is a rare condition that usually affects children, usually between the ages of five and seven. Also called benign occipital epilepsy, the syndrome is characterized by seizures that originate in the occipital lobe at the back of the brain. Some patients experience seizures that are mostly nocturnal, while others tend to only have them during the day. They can be triggered by visual stimulation, although in some cases the seizures occur for no obvious reason. The disorder often leads to symptoms that affect vision, particularly when the patient’s seizures occur during the day, as most of the visual processing occurs in the occipital lobe.
When an occipital seizure occurs, the first symptom is often a visual hallucination. Patients may see flashes of color or light, complex illusions, or images that seem to repeat themselves before their eyes. There may also be other visual effects; for example, partial or total blindness may occur. The eyes may move or jerk uncontrollably from side to side, the eyelids may flutter, and there may be pain in the eyes.
In addition to vision problems, those with occipital epilepsy often experience a variety of other symptoms during seizures. Severe headaches often occur during or after an episode; in many cases, the condition is mistaken for migraine due to these headaches and corresponding visual cues. Many patients also experience nausea and vomiting. Sometimes there will be uncontrollable jerks on one side of the body; this is more common in patients who have nocturnal seizures.
The diagnosis of occipital epilepsy typically begins with a detailed history of the patient’s symptoms. Your doctor may also do a neurological exam to determine if your brain is functioning normally and to see if there is any evidence that mental processing or physical abilities are affected. Electroencephalography, or EEG, is usually very helpful in obtaining an accurate diagnosis, as it can determine which part of the brain is causing the seizures. Visual stimulation such as a flashing strobe light can be used to induce neural activity to aid in the process.
Drug therapy is typically the preferred method of treating occipital epilepsy. Two epilepsy drugs, carbamazepine and oxcarbazepine, have been shown to be effective in controlling seizures in most patients. For those who don’t respond to these drugs, surgery may be a necessary alternative.
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