Benign occipital lobe epilepsy

Benign occipital lobe epilepsy (BOLE) represents a recently delineated form of epileptic seizure disorder. It occurs in children, adolescents, and young adults. The seizures are mostly of visual character with elementary or complex hallucinations, but nonvisual seizures also occur. The EEG usually shows runs of posterior slow spike-wave complexes interictally or during ictal episodes. Migrainelike headache may occur after the seizures and there are certain relationships between BOLE and migraine, but a line must be drawn separating these two conditions. Six typical cases are presented; diagnostic features, differential diagnosis, and possible underlying mechanisms are discussed.