Differential diagnosis of occipital seizures from basilar migraine or migraine with aura.
| Occipital epilepsy | Migraine with aura | Basilar migraine | |
|---|---|---|---|
| Visual hallucinations | |||
| Duration for seconds to a minute | Exclusive | None | None |
| Duration for 1–3 minutes | Frequent | Rare | Rare |
| Duration for 4–30 minutes | Rare | As a rule | As a rule |
| Daily in frequency | As a rule | Rare | None |
| Mainly coloured circular patterns | As a rule | Rare | Exceptional |
| Mainly achromatic or black and white linear patterns | Exceptional | As a rule | Rare |
| Moving to the opposite side of the visual field | Exclusive | None | None |
| Expanding from the centre to the periphery of a visual hemifield | Rare | As a rule | Frequent |
| Evolving to blindness | Rare | Rare | As a rule |
| Evolving to tonic deviation of eyes | Exclusive | None | None |
| Evolving to impairment of consciousness without convulsions | Frequent | Rare | Frequent |
| Evolving to impairment of consciousness with convulsions | Frequent | Exceptional | Rare |
| Associated with post-ictal/post-critical headache | Frequent | As a rule | Frequent |
| Blindness and hemianopia | |||
| Without other preceding or following symptoms | Frequent | None | Frequent |
| Other neurological symptoms | |||
| Brain stem symptoms | None | None | Exclusive |
| Post-ictal/post-critical vomiting | Rare | Frequent | Frequent |
| Post-ictal/post-critical headache | |||
| Post-ictal or post-critical severe headache | Frequent | As a rule | Frequent |
Modified from Panayiotopoulos (1999)357 with the permission of the editor of Epileptic Disorders.
From: Chapter 12, Symptomatic and Probably Symptomatic Focal Epilepsies
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