• Definition
• Causes
• Symptoms
• Diagnosis
• Treatment
• FAQ
• Summary

People with occipital lobe epilepsy (OLE) can experience seizures that affect their vision and other symptoms. While it is treatable, occipital lobe epilepsy symptoms can be similar to and mistaken for several other conditions.

Epilepsy is a condition where a person can experience recurring seizures.

Occipital lobe epilepsy (OLE) is a type of epilepsy that can affect people in childhood. These epilepsy conditions often improve over time.

There are three main types, with different symptoms and types of seizures. OLE is typically treatable with medication.

What is occipital lobe epilepsy?

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OLE is a rare typeTrusted Source of epilepsy. People with OLE usually have seizure symptoms that affect their vision.

Individuals may develop OLE during early or late childhood. However, in rare cases, adults can also develop OLE. This may be due to traumatic brain injury, stroke, tumor, or issues with the vascular structures in the occipital lobe.

There are three main types of OLE. However, certain cases may not fit into either type.

Panayiotopoulos syndrome (PS) OLE

Other names for Panayiotopoulos syndrome include early onset childhood occipital epilepsy and early onset childhood epilepsy with occipital spikes.

Children with PS OLE often experience nausea and vomiting as a part of their seizure symptoms. PS usually develops between the ages of 3 to 6 years. Most do not have more than six seizures in their lifetime and experience typical physical and intellectual development.

Idiopathic childhood occipital epilepsy (ICOE)

Other names for idiopathic childhood occipital epilepsy (ICOE) include late onset childhood epilepsy and late onset childhood epilepsy with occipital spikes.

Children with ICOE normally have seizure symptoms that affect their vision. This condition typically develops between ages 1 to 18 years. More than halfTrusted Source of children with ICOE have symptoms that resolve within 4 years of onset.

Photosensitive occipital lobe epilepsy (POLE)

POLE is most often observable in children between the ages of 4 to 17 years.

Seizures with POLE trigger due to light sources, including video games and television. The seizures are typically brief and include visual sensations, while they may also involve head and eye movements.

Vision center

A person’s occipital lobe is part of the brain that sits at the back of the head. It processesTrusted Source visual information, including how a person perceives:

• color
• form
• motion
• depth perception
• object and face recognition

Read more about the occipital lobe.

Causes of occipital lobe epilepsy

Experts are still investigating the exact cause of PS. However, they believe the causes may includeTrusted Source genetic factors or development issues at birth. They have not yet conclusively identified any genes that cause PS. About 17% of people with PS have a family history of seizures or epilepsy.

In ICOE, about 1 in 3 people have a family history of epilepsy.

Learn more about epilepsy.

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Symptoms of occipital lobe epilepsy

People with OLE may often have symptoms similar to migraine and other conditions that affect the nervous system.

The two main types of OLE have differentTrusted Source symptoms.

PS OLE

Children with PS have symptoms that affect their nervous system, called autonomic symptoms. These can include seizures that occur at night as well as:

• nausea
• vomiting
• vision changes, such as:
  • being unable to see temporarily
  • seeing flashing, colorful, or bright lights
  • having blurry vision
• irritability
• looking to one side
• paleness
• dilated pupils, or mydriasis
• being too hot or too cold
• changes to their heart rate
• incontinence
• producing lots of saliva

These symptoms may last more than 30 minutes. In around 21% to 50% of children with PS, seizures may last for up to 2 hours. They typically start during sleep but can also occur at any time of day.

Doctors consider both of these lengths of seizures long. Generally, if a seizure lasts more than 5 minutes, a person needs medical attention.

The seizure symptoms of PS may be similar to those of:

• fainting
• migraine
• cyclic vomiting syndrome
• motion sickness
• sleep disorders
• stomach flu

ICOE

Children who have ICOE experience seizure symptoms that mainly affect their vision, including:

• headaches
• hallucinations, such as colors or circular dots
• ictal blindness, or blindness that comes and goes with the seizures
• orbital pain, or pain behind the eyes
• nausea
• vomiting
• nystagmus, or rapid movements of a person’s eyes
• turning of a person’s eyes in one direction

Without treatment, children with ICOE may experience frequent seizures, potentially daily. They often occur during the day and last 1 to 3 minutes. Children may experience headaches afterward. ICOE symptoms can appear similar to migraine.

Diagnosis of occipital lobe epilepsy

To diagnose types of OLE, healthcare professionals use descriptions of a person’s seizures and symptoms. They may also use:

• MRI: MRI scans use strong magnetic fields and radio waves to produce images of the inside of a person’s body. For people with OLE, these scans usually give typical results. However, healthcare professionals may use them to rule out other kinds of epilepsy.
• Electroencephalogram (EEG): EEG tests measure electrical activity in the brain using small metal discs on the head. People with OLE will often have evidence of seizure activity in the occipital lobe that is detectable during an EEG.

Treatment of occipital lobe epilepsy

Healthcare professionals commonly use antiepileptic medication to treat OLE, such as:

• carbamazepine
• valproate
• phenobarbital
• levetiracetam
• oxcarbazepine

These medications are generally an effective treatment for OLE. After seizures stop occurring, healthcare professionals may reconsider doses or consider stopping medication for them.

There are some variations in outlook. Some children may not require treatment, while others may need lifelong interventions.

If OLE does not respond well to medication, healthcare professionals may consider surgery.

Some children with PS may require emergency medical treatment if long seizures occur.

Read more about epilepsy medications.

Frequently asked questions

What triggers occipital lobe epilepsy?

Triggers of PS OLE may include fever, while POLE may trigger due to flashing lights, such as television or video games.

How rare is benign occipital epilepsy?

Scientists are unsure exactly how rare benign occipital epilepsy is. The exact rate of cases is currently unknownTrusted Source.

Epilepsy resources

Visit our dedicated hub for more research-backed information and in-depth resources on epilepsy and seizures.

Summary

People with epilepsy experience recurring seizures due to bursts of electrical activity in the brain.

Occipital lobe epilepsy (OLE) is a rare form of epilepsy that typically begins in childhood and usually resolves before adulthood. The occipital lobe is part of the brain that processes visual information.

The three main types of OLE are Panayiotopoulos syndrome (PS), idiopathic childhood occipital epilepsy, and photosensitive occipital lobe epilepsy. Experts do not yet know the exact causes of these types of epilepsy. However, they believe genetic factors play a role.

Healthcare professionals usually use descriptions of a person’s symptoms as well as EEGs and MRI scans to diagnose OLE. They can usually treat OLE with antiepileptic medication. With PS, the seizures are infrequent, and children with this condition may not require medication.