| Identifier |
occipital_seizures_lee_novel |
| Title |
Occipital Seizures |
| Creator |
Andrew G. Lee, MD; Anveet Janwadkar |
| Affiliation |
(AGL) Chairman, Department of Ophthalmology, The Methodist Hospital, Houston, Texas; Professor of Ophthalmology, Weill Cornell Medicine, New York City, New York; (AJ) Class of 2022, Baylor College of Medicine, Houston, Texas |
| Subject |
Occipital Seizures; Seizures |
| Description |
Summary: - Occipital seizures o Key features > Bilateral > Simultaneous > Positive: small, geometric, colored circles > Lasts seconds to minutes > May or may not develop generalized seizure activity, confusion, eye movement/fluttering, gaze deviation > Can cause postictal/ictal blindness o Evaluation > Eye exam usually normal • However, if presence of homonymous hemianopsia, suggestive of structural lesion > Evaluate with an MRI and EEG • MRI usually normal - Benign occipital epilepsy in children o Can take on an autonomic form, presenting as abdominal pain o Child will grow up to have occipital epilepsy |
| Transcript |
All right, today, we're going to be talking about occipital epilepsy, and normally in neuro-ophthalmology, we really don't see epileptic patients or have to treat them, but this one we do, and it's occipital epilepsy is the one we see because it produces visual phenomena. So it's usually bilateral, simultaneous, and positive - that is they see something. It's not usually, "I lost my vision." However, postictal and ictal blindness can occur. And the differentiating feature is it's little tiny circles of color. It's geometric: they're usually very close together, and there are a number of proposed hypotheses about why this occurred, presumably related to the retinotopic organization of the cortex. And the receptive fields on and off can make this kind of geometry (and if you're interested in reading more about that you can see what Turing - of Alan Turing and the Turing machine enigma - that whole story has to say about this pattern, not only in occipital lobe, but in nature in general. Anyway, patients with this often complain of small, geometric, circular, and colored. So, the two features that are very suspicious for occipital seizure are circle and color. It's bilateral and simultaneous. It usually lasts seconds to minutes, and then they may or may not develop generalized seizure activity afterwards or be confused or an eye movement or eye fluttering or gaze deviation. All of those are suggestive that it's seizure. Usually, their MRI scan is normal. Eye exam is usually normal, but if you see a homonymous hemianopsia, then that implies there's a structural lesion. Either way, we're going to do an MRI, look at the lesion, and we need to do an EEG. And in children, the benign occipital epilepsy can take on an autonomic form, and that autonomic form might present as abdominal pain-pale kid who feels sick, and then they may get the colored likes afterwards. And so these have names (you don't have to know these names), but you need to know that childhood epilepsy, the kid eventually grows up, and they have the occipital epilepsy. And so if you hear that story: bilateral, simultaneous, colored little circles, seconds to minutes at a time, you should do an MRI and an EEG. |
| Date |
2021-04 |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Andrew G. Lee Collection: https://novel.utah.edu/Lee/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6z9592t |
| Setname |
ehsl_novel_lee |
| ID |
1680612 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6z9592t |
