Fonseca L C, Tedrus G M
Departamento de Neuropsiquiatria da Faculdade de Ciências Médicas da Pontíficia Universidade Católica de Campinas (PUCCAMP), Brasil.
Arq Neuropsiquiatr. 1994 Dec;52(4):510-4. doi: 10.1590/s0004-282x1994000400009.
Paroxysms of high-amplitude spike-waves or sharp waves recurring rhythmically on the occipital areas when the eyes are closed (POEC) are primarily observed in childhood epilepsy with occipital paroxysms (CEOP). An association of this electroencephalographic (EEG) pattern with idiopathic epilepsy has been disputed. We studied EEG and clinical features in 24 patients (age ranging from 3 to 25 years) with POEC. The EEG showed generalized discharges in 8 cases, rolandic spikes in 4 and background abnormalities in 4 cases. Eighteen (75%) patients manifested epileptic seizures. The nonfebrile seizures (16 cases) were partial (9 cases), generalized (6 cases) and unclassified (one patient). Two children had neurological examination or computed tomography abnormalities. Clinical and EEG data allowed for the following epileptic syndromes diagnosis: CEOP, 7 cases; benign childhood epilepsy with centrotemporal spikes, one case; CEOP or benign childhood epilepsy with centrotemporal spikes, one case; partial symptomatic/cryptogenic epilepsy, 4 cases; generalized idiopathic, 2 cases; febrile convulsions, 2 cases. We conclude that POEC may be observed in cases with different types of idiopathic partial, cryptogenic/symptomatic and idiopathic generalized epilepsies and may also occur in patients with no seizures.
闭眼时枕区有节律地反复出现高幅棘波或尖波阵发（枕区闭眼阵发性放电，POEC）主要见于儿童枕叶癫痫（CEOP）。这种脑电图（EEG）模式与特发性癫痫的关联一直存在争议。我们研究了24例有POEC的患者（年龄3至25岁）的脑电图和临床特征。脑电图显示8例有广泛性放电，4例有中央颞区棘波，4例有背景异常。18例（75%）患者有癫痫发作。非热性发作（16例）为部分性发作（9例）、全身性发作（6例）和未分类发作（1例患者）。2名儿童有神经学检查或计算机断层扫描异常。临床和脑电图数据支持以下癫痫综合征诊断：CEOP，7例；伴有中央颞区棘波的儿童良性癫痫，1例；CEOP或伴有中央颞区棘波的儿童良性癫痫，1例；部分性症状性/隐源性癫痫，4例；全身性特发性癫痫，2例；热性惊厥，2例。我们得出结论，POEC可见于不同类型的特发性部分性、隐源性/症状性和特发性全身性癫痫患者，也可出现在无癫痫发作的患者中。
