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detecting_seizures_during_pediatric_eye_exam [2026/09/20 10:58] – Scott Larsondetecting_seizures_during_pediatric_eye_exam [2026/09/20 11:02] (current) – [Other Benign Infantile Mimics] Scott Larson
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-====== Signs and Symptoms of Seizures detectable Pediatric Eye Exam ======+====== Signs and Symptoms of Seizures detectable during the Pediatric Eye Exam ======
  
 ====Ictal eye and eyelid signs observable during examination==== ====Ictal eye and eyelid signs observable during examination====
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   * Papilledema    * Papilledema 
     * Consider neuroimaging, seizure can rarely be the first symptom of a brain tumor.      * Consider neuroimaging, seizure can rarely be the first symptom of a brain tumor. 
-  * Visual field deficits** (e.g., homonymous quadrantanopia) may reveal a structural occipital lesion causing seizure+  * Visual field deficits(e.g., homonymous quadrantanopia) may reveal a structural occipital lesion causing seizure
   * Characteristic fundus abnormalities    * Characteristic fundus abnormalities 
     * Chorioretinal lacunae in [Aicardi syndrome] presenting with epileptic spasms and hypsarrhythmia.[10]     * Chorioretinal lacunae in [Aicardi syndrome] presenting with epileptic spasms and hypsarrhythmia.[10]
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 One important **non-benign mimic** is **Glut1 deficiency syndrome**, in which paroxysmal eye-head movements often begin before 6 months and precede seizures; these gaze-saccade movements are distinguished from opsoclonus by a clear intermovement fixation interval and a same-direction head movement, and recognition matters because the condition is treatable ([[https://pubmed.ncbi.nlm.nih.gov/?term=Pearson+Paroxysmal+Eye-Head+Movements+Glut1+Deficiency|Pearson et al., Neurology 2017]]). One important **non-benign mimic** is **Glut1 deficiency syndrome**, in which paroxysmal eye-head movements often begin before 6 months and precede seizures; these gaze-saccade movements are distinguished from opsoclonus by a clear intermovement fixation interval and a same-direction head movement, and recognition matters because the condition is treatable ([[https://pubmed.ncbi.nlm.nih.gov/?term=Pearson+Paroxysmal+Eye-Head+Movements+Glut1+Deficiency|Pearson et al., Neurology 2017]]).
 +
 +Spasmus Nutans
 +Benign Tonic Gaze (upgaze or downgaze) 
  
 ===== Key Principle ===== ===== Key Principle =====