Abstracts

Parieto-occipital lobe epilepsy is less frequently encountered than temporal or frontal lobe epilepsy. The seizure semiologic features from parieto-occipital lobe epilepsy may depend on whether patients have central, basal, lateral, or mesial parieto-occipital lobe seizure onsets.
The aim of this study was to analyze the seizure types seen in various forms of parieto-occipital lobe epilepsy in patients who underwent epilepsy surgery and were subsequently seizure-free.
We included patients who had undergone video-EEG monitoring at our institution, and who were seizure-free for at least 12 months after surgery. The videos of the patient[rsquo]s seizures were reviewed separately by two of the authors, PK and FB. Seizure symptomatology was classified based on the Cleveland Clinic seizure classification. We classified our patients based on areas of resection in the parieto-occipital lobe into: central (n=3), lateral (n=3), mesial(n=5) and basal (n=1).
We identified 12 patients (4 pediatrics and 8 adults) with medically intractable parieto-occipital lobe epilepsy, between 1994-2002, who were 12 months seizure free after surgery. Fifty-five seizures were analyzed.
Auras were seen in 7 patients including: somatosensory (n=2), visual (n=2), vertiginous (n=2), epigasteric (n=1), autonomic (n=1) , and undefined (n=2). Alimentary automatisms were seen in 6 patients, behavioral arrest (n=5), bilateral eye blinking (n=3), bilateral tonic (n=3), unilateral clonic (n=3), head [amp]/or eye version (n=4). Duration of seizures ranged from 10 to 169 seconds (mean= 42 seconds).
Somatosensory auras were seen in the central and lateral groups, visual auras in the mesial group, and vertiginous auras in the lateral group. Eye blinking was seen more in the lateral[gt]mesial group, automatisms and behavioral arrest in the lateral and mesial groups, bilateral tonic in the central, lateral and mesial groups, unilateral clonic in the mesial and lateral groups, and versive seizures in the mesial and lateral groups.
The semiology of parieto-occipital lobe seizures is influenced greatly by the location of the seizure focus and spread patterns. This can be helpful in localizing seizure onset within the parieto-occipital lobe in candidates being evaluated for epilepsy surgery.