Occipital epilepsy is a rare condition that usually affects children, typically starting between the ages of five and seven. Also called benign occipital epilepsy, the syndrome is characterized by seizures that originate in the occipital lobe at the back of the brain. Some patients experience seizures that are primarily nocturnal, while others tend to have them only during the day. They may be set off by visual stimulation, though in some cases seizures happen for no obvious reason. The disorder frequently leads to symptoms that impact the vision, particularly when the patient's seizures occur during the day, as the majority of visual processing is done in the occipital lobe.
When an occipital epilepsy seizure occurs, the first symptom is often a visual hallucination. Patients may see flashes of color or light, complex illusions, or images that appear to repeat before the eyes. There may be other visual effects as well; for example, partial or full blindness may occur. The eyes may move or jerk uncontrollably from side to side, the eyelids may flutter, and there may be pain in the eyes.
In addition to visual issues, those with occipital epilepsy often suffer a variety of other symptoms during seizures. Severe headaches often occur during or after an episode; in many cases, the condition is mistaken for migraines due to these headaches and the corresponding visual cues. Many patients also become nauseous and vomit. Sometimes there will be uncontrollable jerking on one side of the body; this is more common in patients who have seizures at night.
Diagnosis of occipital epilepsy typically begins with a detailed history of the patient's symptoms. The doctor may also perform a neurological examination to determine if the brain is functioning normally and to see if there is any evidence that mental processing or physical capabilities are being affected. Electroencephalography, or EEG, is usually then very helpful in obtaining an accurate diagnosis, as it can determine which portion of the brain is generating the seizures. Visual stimulation such as a flashing strobe light can be used to induce neural activity to help aid in the process.
Drug therapy is typically the preferred method to treat occipital epilepsy. Two epilepsy drugs, carbamazepine and oxcarbazepine, have proven effective in controlling seizures in a majority of patients. For those who do not respond to these medications, surgery may be a necessary alternative.
