Childhood epilepsy with occipital paroxysms is an age-related idiopathic focal epilepsy. Occipital EEG paroxysms are considered necessary for diagnosis. We carried out a close clinical and EEG follow-up (range, 2-12 years; mean, 6 years 7 months; median, 7 years) in 24 patients (age range, 4-19 years; mean, 11 years 8 months; median, 11 years). In five children with early seizure onset and particularly benign prognosis without any treatment, EEG abnormalities appeared 3-10 months after the first seizure. Four of them exhibited the ictal pattern of versive seizures with vomiting. Our findings confirm that in the early idiopathic focal seizure disorders, interictal EEG abnormalities may be lacking at the beginning of the disorder.