Acronym for Bening Epilepsy of Childhood with Occipital Paroxysms

(Epilepsy with occipital paroxysms)

Rare. It affects both boys and girls; the first signs appear at 7.5 years of age (range: between 2 and 17 years) later than in the Panayiotopoulos syndrome (see this term). In one third of cases, there is a positive family medical history and in 16 % of cases, there is a notion of migraines. Clinical semiology consists of visual and  non-visual signs.

The visual signs are present at the time of the crisis: amaurosis, basic visual sensations such as phosphenes in all or part of the visual field. Complex visual hallucinations are rare. Non-visual signs usually occur after the visual symptoms: hemiclonic crisis in almost half of cases. It can be complex partial seizures or generalized tonic-clonic seizures.

EEG: it is characterized by discharge of spikes or spike-waves on the two occipital lobes in the post-critical period.The spikes occur rhythmically from 1 to 3 cycles / second. At the opening of the eyes, there is an almost complete disappearance of the paroxysmal images; neither hyperventilation, nor intermittent light stimulation can trigger a crisis. Treatment: carbamazepine or valproate may be proposed. Evolution: in 60% of cases, the control of crises is easily obtained with an antiepileptic monotherapy and the crises disappear at puberty.

Anesthetic implications:

management for a child with seizures

References : 

Updated: November 2019