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Abstract
The authors describe a 12-year-old boy with attacks of leftward conjugate eye deviation due to a right occipital epileptic focus. Further examination revealed a congruous homonymous paracentral left inferior scotoma, typical for a disorder in the right visual cortex at the upper lip of the posterior part of the calcarine fissure, but no structural lesion was found. Epileptic eye deviation with or without nystagmus as isolated phenomenon is in nearly all reports caused by a focus in the parieto-temporo-occipital region, predominantly of the right hemisphere. Usually, the eye deviation is directed contralaterally to the side of the focus, probably resulting from stimulation of the saccadic system. Incidentally, ipsilateral eye deviation occurs, which may be explained by selective activation of the smooth pursuit system.