Clinical Considerations of Panayiotopoulos Syndrome

Kwahk, Jae Hyok; Chi, Hye Mi; Chae, Kyu Young

Abstract

PURPOSE: Panayiotopoulos syndrome(PS) is a benign childhood focal seizure disorder characterized by seizures with emetic symptoms and other autonomic phenomena, and its EEG shows shifting and/or multiple foci, often with occipital predominance. More than 800 cases have been reported worldwide, but no case has been reported in Korea. This paper describes the characteristics of the patients that satisfy the diagnostic criteria of PS and gives its clinical considerations.
METHODS
A total of 140 children with non-febrile seizures visited Bundang Cha General Hospital from June 2004 to June 2005. Among them seven patients satisfied the diagnostic criteria of PS. We analyzed their clinical findings and EEG results retrospectively.
RESULTS
Boys predominated. The mean age at the first seizures was 6.21 years old. Nearly 57% of the cases had at least one seizure lasting more than 30 minutes. Seizures during sleep were more common than those in wakefulness. Seizures started with emesis while the children were usually fully conscious. Other conventional seizure manifestations such as loss of consciousness, eyeball deviation, and convulsions often ensued. The EEG records showed occipital spikes in four patients. Of the other three cases, two had extraoccipital spikes and one had a normal EEG.
CONCLUSION
PS seems to be commonly observed in Korea, although it remains largely unknown in Korea. Since PS, in its early phases, is often indistinguishable from several serious diseases, a good knowledge of the condition can prevent unnecessary examinations and excessive treatment. Further studies are required to establish systematic practice parameter guidelines.