The recognition of a syndrome of early-onset benign childhood occipital seizures (EBOS) is proposed in a report from St Thomas’ Hospital. London, England. The characteristic findings are infrequent partial, usually nocturnal, seizures with deviation of the eyes and vomiting, frequently evolving to hemi- or generalized convulsions, with onset between 1 and 12 years, usually at age 5 years. Behavioral changes with irritability are frequent, and retching, coughing, and incontinence may occur. The prognosis is excellent, one third having only one seizure, and remission occurs within one year from onset. EEG shows occipital spikes, especially in sleep. Centrotemporal spike foci may occur later and a few develop rolandic seizures. [1]

COMMENT. Dr Panayiotopoulos proposes an addition to the classification of childhood epilepsy syndromes, with recognition of an early-onset benign occipital seizure syndrome (EBOS), sharing identical EEG manifestations with late-onset idiopathic occipital epilepsy (LOE), but having more common clinical features with rolandic seizures (BECTS). EBOS are infrequent, mainly nocturnal, and remit usually within one year, whereas LOE are diurnal and usually persist for years. A unified concept for benign childhood partial epilepsies might be preferred, since clinical and EEG characteristics are often shared, and one syndrome may evolve into another. We must await the determination of genetic markers.