DIAGNOSIS OF OCCIPITAL LOBE EPILEPSY

Abstract

Objective . The study aimed to investigate the significance of MRI and video electro-encephalography (EEG) monitoring in diagnosis of occipital lobe epilepsy. Materials and methods. The study involved 103 patients aged 2-17 years old who were diagnosed with occipital lobe epilepsy. All patients underwent brain MRI scans using a CT scanner 1.5 TL in the T1 and T2 modes in the axial, sagittal and frontal planes. For video electro-encephalography monitoring the EEG-recorder Encephalan 9 was used. Results. For the analysis of MRI studies in patients with occipital epilepsy, we grouped the patients as follows: with signs of perinatal brain lesions – 39 patients (38%), with congenital abnormalities of brain development – 26 patients (25%), and those with no pathological findings in the brain structures – 38 (37%). The EEG monitoring results revealed no deviations from the normal background rhythm in 27 patients (26%). Fifty patients (49%) demonstrated abnormalities of the alpha rhythm. In 26 patients (25%) a slowdown of the background rhythm was detected. The results demonstrated that a slowdown and abnormalities of the background rhythm occurred more often in children with symptomatic occipital lobe epilepsy, while these EEG changes occurred the least in patients with Lennox-Gastaut Syndrome. All patients showed the epileptiform activities manifested by the “peak – slow wave” complexes similar to the benign epileptiform rhythm patterns. Conclusion . The results obtained from the brain MRI studies in patients with occipital lobe epilepsy indicate that the perinatal brain damage has a role in the pathogenesis of the disease. The EEG results show that the EEG patterns in Panayiotopoulos Syndrome are more variable as compared to Lennox-Gastaut Syndrome and symptomatic occipital lobe epilepsy.