Clinical and Electrophysiological Characteristics and Prognosis of Childhood Occipital Visual Epilepsy in Light of Current ILAE Criteria


Atacan Yaşgüçlükal M., Güleç B., Emre D. H., ELMALI YAZICI A. D., Ertürk Çetin Ö., Demirbilek A. V.

Clinical EEG and Neuroscience, 2025 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1177/15500594251376396
  • Dergi Adı: Clinical EEG and Neuroscience
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Biotechnology Research Abstracts, EMBASE, MEDLINE
  • Anahtar Kelimeler: childhood occipital visual epilepsy, gastaut syndrome, self-limited epilepsy of childhood, visual hallucinations
  • İstanbul Üniversitesi Adresli: Evet

Özet

Objectives: Childhood Occipital Visual Epilepsy (COVE) is a self-limited epileptic syndrome that typically begins in late childhood or adolescence characterized by brief visual seizures. The recent 2022 International League Against Epilepsy (ILAE) classification distinguishes COVE from photosensitive occipital lobe epilepsy (POLE), emphasizing the absence of photic-induced seizures in COVE. In this study, we aimed to describe the clinical and electrophysiological features of patients with COVE diagnosed according to the new ILAE criteria. Methods: This retrospective cohort study analyzed 30 patients diagnosed with COVE at a tertiary epilepsy center between 1988 and 2023. Patients were selected based on ILAE 2022 criteria, and all cases with intermittent photic stimulation (IPS)-induced seizures were excluded. Results: Most patients (93%) presented with elementary visual hallucinations, such as colorful lights. Orofacial seizures occurred in 7%, and 37% had nocturnal seizures. EEG abnormalities were primarily occipital and resolved in 85% of cases over time. Generalized spike-wave discharges (GSWDs) were rare (5%), and only one patient developed juvenile myoclonic epilepsy during follow-up. At final follow-up, 77% of patients achieved seizure freedom, and 47% discontinued medication. Conclusion: COVE is an epileptic syndrome associated with a favorable prognosis. By excluding photosensitivity in light of the newly proposed diagnostic criteria from the ILAE, future research should focus on a more homogenous group of COVE patients to enhance understanding of this syndrome. Accurate classification using updated ILAE criteria allows for clearer clinical delineation and more reliable outcome predictions.