Sindroma Panayiotopoulos Sebagai Suatu Varian Epilepsi Dengan Bangkitan Otonomik: Sebuah Laporan Kasus Epilepsi Fokal Idiopatik Dengan Gambaran Gelombang Epileptiform Menyeluruh

Abstract

Introduction: Panayiotopoulos syndrome is an age-related idiopathic epilepsy, where the main attack is in the form of autonomic manifestations with triad of emesis: nauseous, retching, and/or vomiting. These attacks are focal seizures, in which the epileptic focus originates from a specific region of the brain, with clinical manifestations depending on the region of the brain involved and where the epileptic focus has spread. About 90% of cases have multifocal sharp and slow wave complex; however, another 2% of cases have brief generalized discharges with spike-wave complex. The diagnosis of Panayiotopoulos Syndrome is based on its characteristic clinical manifestations in the form of triad emesis, in children with a peak age of 5 to 6 years. Case Report: a 10-year-old girl was brought to the neurology clinic of Hospital X for electroencephalography examination. She had an attack in the form of complaints of nauseous, vomiting, palpitations, cyanosis of her lips and fingertips of both hands, also blindness of both eyes. The first attack occurs when the patient was 5 years old; frequency of 1 to 3 times per week, duration of 5 minutes, and the interval between attacks of 1 year. During attack, the patient was conscious. General physical and neurological examinations were within normal limits, while interictal electroencephalography examination showed normal background rhythm with repetitive, paroxysmal, generalized spike and wave. Discussion: Panayiotopoulos syndrome is an age-related idiopathic focal epilepsy, manifested by autonomic seizures. Previous studies have shown that there were variations in the electroencephalographic features of patients with focal epilepsy who have generalized epileptiform discharges, including in Panayiotopoulos Syndrome.