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Is Medication Necessary When Diagnosed With Panayiotopoulos Syndrome?

Posted on Thu, 12 Nov 2015

Question: Would you medicate a 9 year old that has been diagnosed with panayiotopolus syndrome but only had 1 seizure 2.5 years ago. The 1 seizure resulted in status epilepticus which is not uncommon with PS. EEG's each year show continued abnormal spiking but again he has not had any more seizures

Answered by Dr. Neeraj Kumar (21 minutes later)

Brief Answer:
Do not require any medication at present

Detailed Answer:
Hello XXXX,
I have gone through your question and understand your concerns.
Treatment in panayiotopolus syndrome depends upon the seizure frequency and as the child has only one episode then he may not be requiring any medications.
Most children become asymptomatic in 2-3 years and develop normal cognitive skills.
The point to be focussed is to identify the symptoms of panayiotopolus syndrome like syncope, paleness, migraine like headache, vomiting and motion sickness.
Continue monitoring on EEG.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Neeraj Kumar (17 minutes later)

I know all of that but in your opinion, would you medicate a 9 year old uf they only had 1 seuzure?

Answered by Dr. Neeraj Kumar (17 minutes later)

Brief Answer:
Do not require any medication at present

Detailed Answer:
Hello XXXX,
I will not give medication if only one seizure has occurred.
Initial presentation with status epileptics has no different prognosis than a non convulsive presentation in panayiotopolous syndrome.
One dilemma is the initial episode as status epileptics if diagnosis is not made at that time. In such a case most clinician will start anti epileptics in presentation as status epileptics requires treatment.

Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
You can go through a recent article regrading this.
http://www.sciencedirect.com/science/article/pii/S0000

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Neeraj Kumar (25 minutes later)

Would you be concerned that although there has not been another seizure, the annual EEG's for the padt 2 years still show spikes and are not normal? Would abnormal eeg's alone, influence your decision to medicate?

Answered by Dr. Neeraj Kumar (20 minutes later)

Brief Answer:
No treatment required for EEG changes only

Detailed Answer:
Hello,
No, I will not be treating EEG abnormalities if clinically the child is fine.
In some cases the EEG changes may take a bit longer.
Nothing serious at present.
keep monitoring .
Regards
Dr Neeraj Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Yogesh D