Panayiotopoulos syndrome: a clinico-electroencephalographic presentation of three cases from Nigeria


  • Christian Chukwukere Ogoke Department of Clinical Neurophysiology and Child Neurology, Paediatric Neurology Unit, Epilepsy Monitoring Unit, Regions Stroke and Neuroscience Hospital, Mgbirichi, Imo State, Nigeria



Focal aware autonomic seizures, Ictal vomiting, Panayiotopoulos syndrome


Panayiotopoulos syndrome (PS) is a common benign, childhood, focal, seizure susceptibility syndrome presenting with mainly focal aware or focal impaired awareness autonomic seizures and autonomic status epilepticus that is under diagnosed in our locality. Increased awareness through reporting will aid diagnosis, reduce misdiagnosis and prevent aggressive and deleterious interventions. The classic clinical and electroencephalographic (EEG) features of three cases are described and the literature reviewed. The aim is to underscore the presence in our locality of this remarkably benign epileptic syndrome that must be differentiated from febrile seizures, encephalopathy, migraine or cardiogenic syncope.


Panayiotopoulos CP. Benign childhood focal seizures and related epileptic syndromes. In: Panayiotopoulos CP, ed. A clinical guide to epileptic syndromes and their treatment. 2nd ed. London: Springer Healthcare Ltd; 2010:339-375.

Ferrie C, Caraballo R, Covanis A, Demirbilek V, Dervent A, Kivity S, et al. Panayiotopoulos syndrome: a consensus view. Dev Med Child Neurol. 2006;48:236-40.

Covanis A. Panayiotopoulos syndrome: A benign childhood autonomic epilepsy frequently imitating encephalitis, syncope, migraine, sleep disorder or gastroenteritis. Paediatr. 2006;118:e1237.

Chrysostomos P, Panayiotopoulos CP. Autonomic seizures and autonomic status epilepticus perculiar to childhood: diagnosis and management. Epilepsy Behavior. 2004;5:286-95.

Koutroumanidis M. Panayiotopoulos syndrome: An important electroclinical example of benign childhood system epilepsy. Epilepsia. 2007;48(6):1044-53.

Eyong KI, Ekanem EE, Asindi AA, Chimaeze T. Clinical profile of childhood epilepsy in Nigerian children seen in a tertiary hospital. Int J Contemp Pediatr. 2017;4:1138-41.

Ogunlesi T, Ogundeyi O, Olowu A. Pattern of childhood epilepsies in Sagamu, Nigeria. Indian J Pediatr. 2009;76:385-9.

Lagunju IA, Fatunde OJ, Takon I. Profile of childhood epilepsy in Nigeria. J Paediatr Neurol. 2009;7:135-40.

Lagunju IA, Oyinlade AO, Atalabi OM, Ogbole G, Tedimola O, Famosaya A, et al. Electroencephalography as a tool for evidence-based diagnosis and improved outcomes in children with epilepsy in a resource-poor setting. PAMJ. 2015;22:328.

Pandey S. Challenges in neurological practice in developing countries. Indian J Public Health. 2012;56:227-30.

Mclane HC, Berkowitz AL, Patenaude BN, Mckenzie ED, Wolper E, Wahlster S, et al. Availability, accessibility, and affordability of neurodiagnostic tests in 37 countries. Neurol. 2015;85:1614-22.

Panayiotopoulos CP. Idiopathic epileptic seizures and syndromes in infancy. In: Panayiotopoulos CP, ed. A clinical guide to epileptic syndromes and their treatment. 2nd ed. London: Springer Healthcare Ltd; 2010:339-375.

Fisher RS, Cross H, D’Souza C, French JA, Haut SR, Higurashi N, et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia. 2017;58(4):531-42.






Case Reports