The seizure process is often accompanied by eye movement disorders and pupil changes. In addition to the common head-eye turning, this can manifest as eyelid spasms and persistent nystagmus. These rare symptoms are easily confused with central nervous system lesions and vestibular lesions, causing misdiagnosis in clinical practice. We report 4 cases of seizures presenting with specific ocular symptoms, which are summarized below. Case 1: Male, 10 years old, with normal birth and developmental history. 2.2 years old after receiving BSE vaccination, he developed blinking of the right eye at night when he first fell asleep, which lasted for 3 seconds. Later on, the blinking occurred during the day, with about 100 episodes per day. She was considered to have “oculomotor spasm”. Oral treatment with clonidine, magnesium valproate and carbamazepine was effective. After 2 years of self-medication discontinuation, the symptoms recurred, with more than 10 episodes per day for 3 seconds each time, sometimes accompanied by a seeming upward movement of air from the nose to the eyes and twitching of the right hand. Neurological examination did not show any abnormality. Video-EEG examination showed that there were more slow waves in the left frontal region than in the right; during the examination, the patient had one seizure, which was characterized by incessant blinking of the right eye, sitting up from the recumbent position, accompanied by dazedness, lasting for about 10 seconds, while EEG showed a combination of high amplitude sharp and slow waves in the frontal leads bilaterally. The diagnosis was: focal seizures, frontal lobe epilepsy. He was seizure-free for 2 years after the administration of a combination of Depakene and Deritol. VEEG was repeated (-). Case 2: Male, 19 years old, with one unexplained convulsion at 3 days of life. 8 years old with twitching of limbs during sleep, eyes rolling upward, foaming at the mouth, clenching of teeth, and loss of consciousness lasting 1-2 minutes, with one seizure about 2 years; the same year with episodic left eyelid fluttering, flashing in front of the eyes, and visual hallucinations, with about 1-2 seizures per year. There were no episodes of apoplexy or myoclonus. Neurological examination (-). Cranial CT (-); VEEG showed: moderate wave amplitude spike wave issuance visible in the right occipital region. The diagnosis was: occipital lobe epilepsy. Seizure-free for 1.5 years after treatment with Delidor. Case 3: Male, 44 years old. Past history (-). twitching of the limbs, head and eyes turned to the left, persistent horizontal nystagmus in both eyes, foaming at the mouth, loss of consciousness lasting 3-4 minutes started at the age of 20 years; sometimes seizure froze, smacked his lips, and groped his hands for 1-2 minutes. Neurological examination (-). Cranial MRI (-); 24-hour videotaped EEG monitoring was performed: VEEG during the seizure phase showed bilateral frontal moderate amplitude sharp waves, with the right side being the most predominant. The diagnosis was: frontal lobe epilepsy. Case 4: Male, 16 years old. Past history (-). episodes of rapid right eyelid fluttering with clear consciousness and no limb jerking for 10 seconds started at the age of 6 years. It was sometimes accompanied by a head-eye turn to the left and left hand straightening and raising during the seizure. The seizure is preceded by head discomfort. On average, there were 1-2 seizures per week. Neurological examination (-). MRI of the head (-); VEEG during seizures showed bilateral prefrontal medium-amplitude spikes, with a predominance of the right side.PET examination showed left frontal hypoperfusion during the interictal period. The diagnosis was: frontal lobe epilepsy. Gastaut’s term “oculoclonic epilepsy” generally refers to a type of rotational seizure manifested by bilateral lateralized rhythmic clonus of the eyeballs, caused by discharges in the occipital region. 2001 In 2001, the terminology and nomenclature committee of the International League Against Epilepsy also included “oculoclonus” as a separate seizure type. Previous reports in the literature have suggested that the firing sites are in the parieto-occipital, temporo-occipital and frontal central regions. Garcia-Pastor reported a case of occipital lobe epilepsy in which a patient presented with horizontal nystagmus in the contralateral fast phase with visual hallucinations, considering that the fast phase was associated with the cortical Hughes et al. suggested that the discharge causing epileptic nystagmus originated in the amygdala and activated the subcortical ponto-geniculo-occipital system, whereas Grant suggested that it was also associated with supranuclear inhibition of the ipsilateral gaze center. Subtle eyelid fluttering can sometimes be seen in aphasic seizures. One study found a nerve fiber liaison between the temporoparieto-occipital cortex, where epileptic nystagmus occurs, and the oculomotor center of the brainstem in children before the age of 10 years. Our study identified seizures related to ocular activity only in frontal and occipital lobe epilepsy, speculating that there may be rich neural liaison pathways in addition to the anatomical site of origin of discharges related to eye movements. In addition to ocular seizure symptoms, the vast majority of patients with frontal and occipital lobe epilepsy are accompanied by other phenotypes of focal seizures, such as fugue, visual hallucinations, and secondary tonic-clonic seizures. These features all contribute to the differential diagnosis of the disease clinically, and attention should be paid to differentiating it from eye spasms, Meige’s syndrome, and tic disorders. EEG findings of epileptiform discharges can clarify the diagnosis of epilepsy. The treatment of this type of seizure follows, in principle, the treatment plan for focal epilepsy and adheres to the principle of individualization. Antiepileptic drugs are preferred to carbamazepine, and topiramate, lamotrigine, and levetiracetam can be added if necessary. The combination of carbamazepine and sodium valproate can be given for frontal lobe epilepsy and has been shown to have good efficacy. The key to successful treatment is a clear diagnosis of epilepsy, while the type and cause of seizures must be distinguished, and to do this, not only is it necessary to be familiar with the characteristics of the various types of seizures, but a formal detailed video EEG is essential.