Early (PANAYIOTOPOULOS) or BECOP (Benign epilepsy of childhood with occipital paroxysms).

Panayiotopoulos

• Or Self limiting epilepsy with autonomic symptoms (SeLEAS)
• Usually 3-5yrs but can be 1 to 15
• Mostly nocturnal
• Characteristically autonomic – pallor/flushing/vomiting/coughing!
• Head/eye deviation, then tonic-clonic (one sided or generalized)
• Often status, but actually seizures infrequent
• EEG can be normal – sleep EEG more sensitive
• Good prognosis – most remit with a few years and have just a few seizures
• Valproate or carbamazepine

BECOP

• Usually middle childhood, cf above
• Can be triggered by going from dark to light areas or vice versa
• Visual  – partial or complete loss, flashing lights, multi-coloured circles, balls, rarely hallucinations
• Headache during or after – cf migraine!
• Often one side jerks; rarely generalized
• Carbamazepine or Valproate
• Usually benign, most remit by puberty