Photosensitive Occipital Lobe Epilepsy (POLE)

 

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    What is photosensitive occipital lobe epilepsy (POLE)?

    Photosensitive occipital lobe epilepsy is a very rare condition with an estimated occurrence in 0.7% of childhood epilepsies. This syndrome was formerly known as idiopathic photosensitive occipital lobe epilepsy. 

    Who gets POLE?

    POLE is most often diagnosed in children and adolescents between ages 4-17. Females are more often affected than males and a family history of the condition is seen in a third of patients.  

    What types of seizures are seen?

    In photosensitive occipital lobe epilepsy, seizures are triggered by light sources like televisions and video games. Seizures are brief and include visual sensations. Some seizures begin as focal aware seizures and include head and eye movements. Rarely, seizures generalize into tonic clonic seizures.  

    How is POLE diagnosed?

    POLE is diagnosed using MRI and EEG testing. Additionally, doctors will ask for a detailed medical history from the patient. MRI is used to rule out any structural cause for seizures. EEGs will show a normal background but have characteristic occipital spike wave activity. When diagnosing POLE, children may be able to describe or draw what they see including lights, spots, and blurred vision. 

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    Diagnosing Epilepsy

    How is it treated?

    Commonly used anti-seizure medications like valproic acid, levetiracetam, topiramate, zonisamide, or clonazepam and other benzodiazepines are used for treatment. Doctors will also recommend avoiding seizure triggers like certain video games and sleep deprivation. This can help with seizure control and management. 

    What is the outlook?

    The outlook for people diagnosed with POLE varies. Some patients will have only a few seizures while others will have more frequent light-induced seizures.  

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    Light as a Seizure Trigger

    Authored By:

    Charuta Joshi MD

    on Tuesday, March 19, 2024

    Reviewed By:

    Elaine Wirrell MD

    on Tuesday, March 19, 2024

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