EEG Characterizations and Clinical Features in Sudanese Patients with Panayiotopoulos Syndrome

Abstract

Introduction: Panayiotopoulos syndrome (PS) is an age-related, and a relatively frequent benign epileptic syndrome, characterised by predominantly autonomic symptoms and/or simple motor focal seizures followed, or not, by impairment of consciousness. Interictal electroencephalograph (EEG) shows occipital spikes, although multifocal spikes with high amplitude sharp-slow wave complexes at various locations can be present.PS mimics gastroenteritis, encephalitis, syncope, migraine, sleep disorders or metabolic diseases. Aim: The aim was to characterise the EEG waves among Sudanese patients with PS, presented at the EEG unit of The National Ribat University, and El magzoub neurosciences center. Patients and Methods: Out of 4319 abnormal EEGs and based on the classical EEG findings and clinical presentations, the EEG of patients suggestive of PS were identified. Results: EEG findings of patients with PS in the study agree with classical international studies, as they were clustering of sharp and slow waves, sometimes associated with brain spiking, but usually shifting from one region to the other with dominant occipital paroxysms of   sharp and slow waves. GIT upsets were the cardinal autonomic features; abdominal pain and vomiting were constant symptoms in most of the patients. Past history of febrile convulsions was positive in more than one-fourth of patients. All patients experienced febrile convulsions and this may be the main cause of seeking medical advice. Conclusion: The results indicate that Panayiotopoulos syndrome in Sudanese children is not uncommon; moreover, the under diagnosis appears to be high. The classical autonomic manifestations and EEG features of Panayiotopoulos syndrome were well defined in Sudanese patients. EEG shows occipital or extra-occipital abnormalities.