Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Occipital lobe epilepsy in children can present as an idiopathic form (i.e., childhood epilepsy with occipital paroxysms) or as a symptomatic form. Forty-three children (18 boys, 25 girls) were divided into the idiopathic group or symptomatic group, according to the classification for epileptic seizures of the International League Against Epilepsy. Patients in the idiopathic group were further subdivided into the Panayiotopoulos or Gastaut type, according to clinical presentation. The idiopathic group consisted of 15 children (5 boys, 10 girls), of whom 11 were of the Panayiotopoulos type and 4 of the Gastaut type. The symptomatic group consisted of 28 children (13 boys, 15 girls). The average age of seizure onset in the idiopathic group was younger than in the symptomatic group (6.5 +/- 2.4 vs 8.5 +/- 3.0 years). Ictal vomiting was more common in the idiopathic group, and positive visual symptoms were more common in the symptomatic group. Mean epilepsy duration in the idiopathic group was shorter (5.7 +/- 5.3 vs 20.1 +/- 16.0 months), and the response to treatment was better. The average age of seizure onset was much younger in the Panayiotopoulos than in the Gastaut type (5.4 +/- 1.5 vs 9.5 +/- 1.5 years), and mean epilepsy duration was also shorter (3.9 +/- 4.2 vs 10.5 +/- 4.9 months). Seizure semiology can distinguish between idiopathic occipital lobe epilepsy and the symptomatic form with ictal vomiting and positive visual symptoms. In idiopathic occipital lobe epilepsy, the Panayiotopoulos type has better prognosis than the Gastaut type.
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PMID:Clinical analysis of childhood occipital lobe epilepsy in 43 Taiwanese patients. 1756 May

Occipital lobe epilepsy of childhood includes two entities: Panayiotopoulos syndrome in pre-school children, and idiopathic childhood occipital epilepsy of Gastaut (ICOEG) in school-age children. The typical initial manifestation of the former is vomiting, and that of the latter is visual hallucinations. Ictal cardiopulmonary arrest at initial presentation has been reported for Panayiotopoulos syndrome, but not for ICOEG. We document a 7-year-old previously healthy girl who experienced an acute elemental visual hallucination of seeing insects, followed by a new-onset generalized seizure. Upon arrival at the local hospital, she was unconscious and soon thereafter, developed respiratory arrest. She was resuscitated and initiated on mechanical ventilation. An electroencephalogram taken three days after seizure cessation showed frequent occipital spikes, consistent with the diagnosis of ICOEG. The sequence of acute elementary visual hallucination followed by a motor seizure, and then witnessed respiratory arrest illustrated occurrence of life-threatening autonomic involvement at initial onset in ICOEG. We speculate that the epileptic propagation from the occipital lobes eventually compromised the respiratory center in the brainstem. The possibility of occipital lobe epilepsy should be considered in school-age children presenting with acute visual hallucination followed by respiratory arrest. Such a presentation should prompt an urgent electroencephalogram and initiation of antiepileptic treatment if indicated.
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PMID:Respiratory arrest at the onset of idiopathic childhood occipital epilepsy of Gastaut. 2873 92