Isolated Paroxysmal Right Upward Eye Deviation as the Sole Semiology of Childhood Occipital Epilepsy: An Electroclinical Case Report
Clinical EEG and Neuroscience, cilt.57, sa.5, ss.438-441, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 57 Sayı: 5
- Basım Tarihi: 2026
- Doi Numarası: 10.1177/15500594261462223
- Dergi Adı: Clinical EEG and Neuroscience
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Sayfa Sayıları: ss.438-441
- Anahtar Kelimeler: childhood occipital epilepsy, electroencephalography, eye deviation, focal seizure, upgaze
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Isolated paroxysmal eye deviation in children is often considered a benign nonepileptic phenomenon. When epileptic in origin, gaze deviation is usually accompanied by visual symptoms, autonomic features, impaired awareness, or additional motor manifestations. Case: We report a 6-year-old boy with frequent daily episodes of brief right upward eye deviation without impaired awareness, visual symptoms, head version, or other ictal features. Neurological and ophthalmological examinations, routine laboratory investigations, and brain magnetic resonance imaging were unremarkable. Video-electroencephalography demonstrated repetitive spike-wave discharges over the left occipital region, supporting an epileptic origin. Results: Carbamazepine treatment markedly reduced episode frequency, and the spells resolved completely after dose adjustment during follow-up. Next-generation sequencing analysis of calcium channelopathy-related genes revealed no pathogenic variants. Conclusions: This case highlights that isolated paroxysmal right upward eye deviation, even in the absence of other ictal features, may represent a focal preserved consciousness seizure rather than a benign ocular phenomenon. Early electroencephalographic evaluation is essential in children with frequent or atypical paroxysmal eye movements to avoid misdiagnosis and delayed treatment.