A comparison of occipital and temporal lobe epilepsies

Abstract

Occipital lobe epilepsy is difficult to identify and may masquerade as temporal lobe epilepsy. Visual symptoms and occipital findings in the EEG suggest the diagnosis of OLE, but absence of these features, does not exclude the diagnosis. When posterior temporal EEG findings or multilobar involvement occurs, the diagnosis of OLE should be considered.

Seizure Outcomes in Occipital Lobe and Posterior Quadrant Epilepsy Surgery: A Systematic Review and Meta-Analysis

“…Twenty-seven prospective or retrospective case series reporting postoperative seizure outcomes and associated factors in patients undergoing surgery for drug-resistant OLE were analyzed. 3–5,8–15,25–38 The PubMed search did not identify any usable prospective controlled trials. In total, these studies included 584 patients, with 6 to 52 individuals per report (Table 1).…”

Evolution of patients with surgically treated drug-resistant occipital lobe epilepsy

“…[ 8 ] Typically, this type of epilepsy has been associated with the appearance of visual symptoms (e.g., visual hallucinations, campimetric defects, transient amaurosis or eye movement sensation, among others) and occipital abnormalities in the electroencephalogram (EEG), although these findings are not present in all patients and their absence does not rule out the diagnosis. [ 1 ] In certain cases, this pathology can be manifested by altered level of consciousness and/or generalized tonic-clonic activity. This semiology is due to the fact that the seizures originated in the posterior cerebral cortex can spread rapidly to other cortical areas, giving symptoms more related to the diffusion zone of the crisis than to its origin.…”

Occipital ulegyria causing epilepsy and visual impairment: an easily overlooked epilepsy syndrome

“…Watershed zones between the major cerebral arteries in the term newborn are vulnerable to reduced perfusion. While this rate is lower than the 33% frequency of occipital lobe spikes reported in other series of posterior-onset epilepsy, it does emphasise that interictal epileptiform activitiy in the occipital lobe is not a consistent feature (Appel et al, 2015). Interestingly, ulegyria is thought to most commonly involve the occipital lobes (Kuchukhidze et al, 2008).…”

“…In addition, rapid ictal propagation to more anterior brain regions, along with normal and non-specific interictal EEG abnormalities, complicated the interpretation of the seizure-onset zone. Previous series of occipital lobe epilepsy have reported visual seizure symptomatology in 40% of cases (Appel et al, 2015). Ulegyria is a relatively common consequence of hypoxic-ischaemic encephalopathy.…”