Benign epilepsy of childhood with occipital paroxysms (BECOP) can start at any age from 15 months to 17 years. But it usually begins in middle childhood between seven and 11 years of age. This epilepsy syndrome is often called ‘late-onset occipital epilepsy’ to separate if from ‘early-onset occipital epilepsy’, also known as Panayiotopoulos syndrome.
About one third of children have a family history of epilepsy. Some children have had seizures with feverish illnesses (febrile convulsions) before starting to have BECOP. Most children with this condition have normal neurological and learning abilities. Brain scans are normal.
In the electroencephalogram (EEG), which records the electrical activity in the brain, abnormalities are seen in the occipital region (the very back part of the brain). As a result, some children may have seizures as they go from a dark area into a brighter area, or from a well-lit area into a dark area.
The seizures usually affect vision. Complete or partial visual loss happens in about half the children who have this type of epilepsy. Some may experience a sensation of flashing lights, often multi-coloured spots. Visual hallucinations (seeing things) are rare, but happen in some children. About half have jerking of one side of the body. Semi-purposeful movements and behaviour is rarer. Generalised tonic-clonic seizures may also happen. Headaches, during or after the seizure, are a very common feature of this epilepsy syndrome.
The seizures respond readily to epilepsy medicines such as sodium valproate (Epilim), or carbamazepine (Tegretol). There is currently no information as to whether the newer epilepsy medicines such as Lamictal (lamotrigine), Keppra (levetiracetam) or Topamax (topiramate) may also be helpful in this syndrome.
There may be research studies open that are relevant to this epilepsy syndrome. Your child’s doctor will be able to discuss this with you.
Information about treatments for children can be found on the Medicines for Children website.
The outlook is good for neurological development. There are educational problems only in rare cases. The seizures usually get better by puberty, but in 5 to 10 out of 100 cases they carry on into adulthood.
What is a syndrome?
A syndrome is a group of signs and symptoms that, added together, suggest a particular medical condition. In epilepsy, examples of these signs and symptoms would be things like the age at which seizures begin the type of seizures, whether the child is male or female and whether they have physical or learning disabilities, or both. The results of an EEG are also used to help identify epilepsy syndromes.
If you would like to know more about an epilepsy syndrome, please speak to your doctor. If you would like to know more about epilepsy in general, please contact Epilepsy Action.
Epilepsy Action would like to thank
• Dr Richard Appleton, and Dr Rachel Kneen, consultant paediatric neurologists at Alder Hey Children’s Hospital, Liverpool, UK and
• Dr Stewart Macleod, consultant paediatric neurologist at Royal Hospital for Sick Children, Glasgow, UK.
They have kindly prepared the information on this page. It is based on their own research, experience and expertise.