Occipital Lobe Seizures

Focal epileptic seizures are a type of epilepsy. They start in specific parts of the brain called lobes. Occipital lobe seizures start in the occipital lobe of the brain.

The occipital lobe is located at the bottom back of the brain. This is near where the skull and neck meet at the back of the head. The occipital lobe helps with vision and making sense of what the eyes see. It helps with

Depth perception
Colour recognition
Identifying faces
Identifying objects
Forming memories

Occipital lobe seizures are rare. Only 5-10% of focal epilepsies are occipital lobe epilepsies. These can occur in children or adults. They are often initially misdiagnosed as migraine headaches.

Symptoms

Because of the occipital lobe’s functions, many of the symptoms of these seizures are visual. They include:

Seeing colourful bright or flashing lights
Visual hallucinations
Headache
Nausea or vomiting
Partial blindness
Blinking or fluttering eyelids
Seeing repeating images
Eye pain
Uncontrolled eye movement

Causes & Risk Factors

There are many reasons why occipital lobe seizures can occur, such as:

A lesion in the occipital lobe of the brain. This can include a growth (either benign or cancerous) or an injury to the area
Trauma
Infection
Birth defects
Genes

Occipital lobe seizures may occur in some people who have these diseases:

Coeliac disease – this is an autoimmune disease where the body is unable to process gluten. Gluten is a component of wheat. For these patients, eating gluten causes the immune system to attack the body’s intestines.
Lafora disease – a very rare inherited disease in children. Patients have seizures, trouble walking and confusion.
Mitochondrial disease – another very rare genetic disease. The cells in the patient’s body have difficulty making enough energy.

Some triggers which can provoke seizures include:

Blinking or flashing lights
Stress
Not getting enough rest

Diagnosis

A doctor will request several tests to diagnose occipital lobe seizures, such as:

Electroencephalogram (EEG) – this is a test where electrodes are placed on the patient’s scalp. The EEG shows abnormal electrical activity in the brain when a seizure is occurring. It can also help pinpoint where the abnormal activity is in the brain.
Imaging studies such as CT scans or MRI – these can show if there is a lesion or physical abnormality in the brain
Blood tests
Intracranial EEG – a specialist test where electrodes are surgically placed inside the skull onto the surface of the brain. Once the patient’s skull is replaced and bandaged, any anti-epileptic medication will be slowly tapered down. This is so that the patient has a seizure while in the hospital. The electrodes then record where the seizure started. Sometimes more than one seizure is needed to confirm this. Once confirmed, the electrodes are surgically removed. An intracranial EEG is a very specialised test which is only performed at specialist centres. It is only used if a regular EEG where electrodes are attached to the scalp does not provide the information needed.

Treatment

The first line treatment is anti-epilepsy medications. Some examples are:

Carbamazepine
Levetiracetam
Lamotrigine

If there is a lesion or mass in the brain, surgery may be the best option. The type of surgery depends on the location of the lesion.

If the seizures are associated with coeliac disease, a gluten-free diet is recommended.

There are also several different devices available in specialised epilepsy centres. These all-use pulses of electrical energy to prevent seizures. These may be recommended in cases where medication alone does not control the seizures.

Occipital Lobe Seizures

Symptoms

Causes & Risk Factors

Reference Articles

Diagnosis

Treatment

Conditions & Medications

References

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