May 2, 2016: Panayiotopoulos syndrome

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May 2, 2016

Panayiotopoulos syndrome

As one the benign focal epilepsies of childhood, Panayiotopoulos syndrome can be a great mimic.  It is characterized by autonomic symptoms, such as ictal syncope, vomiting, pallor, and headaches. During ictal syncope events the child will become suddenly flaccid and unresponsive, without any triggers.  More typical epileptic phenomena with motor signs and eye deviation can also occur. The most common finding is bilateral occipital spikes. There is no recommended treatment for Panayiotopoulos syndrome; however, carbamazepine and sodium valproate is useful for prophylaxis in patients whose seizures are particularly frequent or distressing.

  1. Koutroumanidis M, Ferrie C, Valeta T, Sanders S, Michael M, Panayiotopoulos C. Syncope-like epileptic seizures in Panayiotopoulos syndrome. Neurology 2012; 79: 463-467.
  2. Ferrie CD, Caraballo R, Covanis A, et al. Autonomic Status Epilepticus in Panayiotopoulos Syndrome and Other Childhood and Adult Epilepsies: A Consensus View. Epilepsia 2007; 48: 1165-1172.

Submitted by Sarah Wesley, MD, Mount Sinai Beth Israel Medical Center, Department of Neurology.

Dr. Wesley is a member of the Resident and Fellow Section of Neurology.

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