Eyelid fluttering accompanying diffuse epileptic EEG induced by eye closure

A 13-year-old male exhibited the following clinical and electroencephalographic (EEG) manifestations. He exhibited marked photosensitivity on EEG from the first visit at 9 years of age until 11 years of age and had an episode of television epilepsy at 9 years of age. Generalized epileptic EEG findings followed by marked eyelid fluttering, induced by eye closure in a bright room that lasted until the eyes were opened, but not by eye closure in a dark room, were first noticed at 11 years of age. A generalized epileptiform EEG was not induced when the light was turned off if the eyes were kept open. His photosensitivity disappeared by 12 years of age, but the eyelid fluttering with epileptic EEG induced by eye closure was still present at 13 years of age. The epileptic EEG was thought to be induced by a modification of the retinal input on eye closure, not by mechanical or sensory stimulation on eye closure or fixation-off sensitivity. In addition, in this patient a change from photosensitive to eye closure-sensitive epilepsy seemed to occur, which suggests that the correlation between the epileptic EEG and retinal input are complex.