Occipital Lobe Epilepsy

What is Occipital Lobe Epilepsy?

In occipital lobe epilepsy, seizures arise from the occipital lobe of the brain, which sits at the back of the brain, just below the parietal lobe and just behind the temporal lobe. The occipital lobe is the main center of the visual system. Occipital lobe epilepsy accounts for about 5-10% of all epilepsy syndromes. This kind of epilepsy can be either idiopathic (of unknown, presumed genetic, cause) or symptomatic (associated with a known or suspected underlying lesion). Benign occipital epilepsies usually begin in childhood and are discussed elsewhere.

Occipital seizures usually begin with visual hallucinations like flickering or colored lights, rapid blinking, or other symptoms related to the eyes and vision. They may occur spontaneously but can often be triggered by particular visual stimuli, such as seeing flashing lights or a repeating pattern. Occipital seizures are often mistaken for migraine headache because they share similar symptoms including visual disturbances, partial blindness, nausea and vomiting, and headache.

What are Occipital Lobe Seizures Like?

The following are the different types of seizure symptoms associated with occipital lobe seizures:

  • Visual hallucinations and/or illusions
  • Blindness or decreased vision
  • Pallinopsia or image repetition ( a visual image is replayed again and again)
  • Sensation of eye movements
  • Eye pain
  • Involuntary eye movement to one or other side
  • Nystagmus or eye jerking to one or other side (Nystagmus is rapid involuntary rhythmic eye movement, with the eyes moving quickly in one direction (quick phase), and then slowly in the other (slow phase),
  • Eyelid fluttering

How is Occipital Lobe Epilepsy Diagnosed?

As with any epilepsy syndrome, detailed patient history, neurological examination, and EEG are very important. In occipital lobe epilepsy, the EEG may provide information that is very helpful in making the correct diagnosis. An abnormal response in the EEG to intermittent photic stimulation (rapidly flashing strobe light) often occurs in occipital lobe epilepsy. However, this response can occur in other epilepsy syndromes as well.

How is Occipital Lobe Epilepsy Treated

Treatment with a drug used for partial epilepsy, often carbamazepine, is usually effective. In intractable cases (those that do not respond to medication), surgical options may be considered.