Benign occipital lobe seizures: Natural progression and atypical evolution
A 14-year-old boy presented with history of seizures involving all four limbs since the age of 7 years.\nThe current clinical seizures are characterized by initial grunting and face turning to the right followed by jerking of all four limbs lasting for a few minutes. The boy remains in a confused state for at least 30 min after seizures. He was treated with VAP 300 mg BD, carbamazepine (CBZ) 200 mg BD and clonazepam (CLN) 0.5 mg: 1-0-2 at the time of presentation []. The working diagnosis at this time was primary generalized seizures. EEG then showed evidence for bilateral occipital spike and wave discharges, which led to further questioning and this revealed additional blurring of vision preceding the generalized seizures and also independent brief episodes with just blurring of vision, which actually started well before the generalized clinical seizures.\nA diagnosis of occipital seizures was made and drugs modified. CBZ was increased to 300 mg BD and CLN reduced to 1 mg OD (noc) and VAP to 500 mg OD (noc).\nImaging studies were normal [].\nSeizures are better controlled now with reduction from weekly seizures to one seizure in the last 3 months.