CHILDHOOD OCCIPITAL VISUAL EPILEPSY (COVE)

OVERVIEW

Childhood occipital visual epilepsy is a self-limited focal epilepsy syndrome, with characteristic focal sensory visual seizures in wakefulness. Seizures are brief but frequent, but usually respond to anti seizure medication and remission occurs in nearly all cases by puberty. This syndrome was previously known as late onset (benign) childhood occipital epilepsy or idiopathic childhood occipital epilepsy-Gastaut type.

NOTE Self-limited refers to there being a high likelihood of seizures spontaneously remitting at a predictable age.

Clinical context

This syndrome is characterized by onset of seizures between 1-19 years of age (peak 8-9 years). Both sexes are equally affected. Antecedent and birth history is normal. Head size and neurological examination are usually normal. Development and cognition are normal, although mild cognitive impairment has been described. Remission occurs in 50-80% of cases by puberty.

CAUTION This syndrome can evolve to developmental and/or epileptic encephalopathy with spike-wave activation in sleep consider a sleep EEG if there is cognitive deterioration.