Coexistence of fixation-off sensitivity and inverted fixation-off sensitivity in a female child with Panayiotopoulos syndrome: Video-electroencephalography documentation☆

Fixation-off sensitivity (FOS) is a rare phenomenon elicited by elimination of central vision and fixation, which even in the presence of light induces occipital paroxysms or generalized paroxysmal discharges. It is most commonly encountered in patients with idiopathic childhood occipital epilepsies but may also be observed in cases of symptomatic focal and generalized epilepsies. We describe a female Emirati child with Panayiotopoulos syndrome who exhibited FOS in addition to the reverse phenomenon called "inverted fixation-off sensitivity," in which the electroencephalographic discharges were suppressed by the absence of central vision or fixation and activated by central vision or fixation.