Abstract:
PURPOSE:To describe a previously unreported type of self-induced pattern-sensitive seizures in a child. METHODS:Evaluation of clinical and EEG features. RESULTS:An 18-month-old boy was initially seen with series of short focal tonic seizures self-induced by gazing intermittently at round objects. Self-induction of these seizures had an obvious relieving effect on the child. Covering the round object foiled further seizures but resulted in a tantrum. Later in the course, an increasing variety of patterns proved to be capable of inducing seizures, which occurred with increasing frequency and severity, including secondarily generalized tonic-clonic seizures. Interictal EEG revealed multifocal sharp-and-slow-waves. Ictal EEG showed no abnormalities during short focal seizures and rapidly generalizing epileptic discharges during a secondarily generalized seizure. No photosensitivity was noted. Motor and mental development of the boy stagnated over a period of 2 years. Behavioral therapy as well as medical treatment, consisting of various combinations of antiepileptic drugs (AEDs) together with a selective serotonin-reuptake inhibitor, were of merely transient benefit. Only combined pharmacotherapy, including valproate, sulthiame, and clobazam, resulted in seizure control at age 3 years 9 months. CONCLUSIONS:Visual capture of geometric patterns other than stripes or gratings may trigger focal seizures with secondary generalization. Synchronization of cortical neurons responsible for pattern recognition may account for epileptogenesis in this child.
journal_name
Epilepsiajournal_title
Epilepsiaauthors
Brockmann K,Huppke P,Karenfort M,Gärtner J,Höger Cdoi
10.1111/j.1528-1167.2005.54004.xsubject
Has Abstractpub_date
2005-05-01 00:00:00pages
786-9issue
5eissn
0013-9580issn
1528-1167pii
EPI54004journal_volume
46pub_type
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