Eye closure sensitivity and epileptic syndromes: A retrospective study of 26 adult cases

The transient, mainly generalized, together with brief changes in EEG baseline immediately after eye closure, is called 'eye closure sensitivity' (ECS) which was first reported by Robinson in 1930 and there have been limited number of studies investigating ECS and epilepsy syndromes. Therefore, we aimed to reveal the possible relationship between ECS and the epilepsy syndromes in our adult patients.

Adult patients monitored in Hacettepe University Hospitals EEG Laboratory, from January 1995 to December 2005, were screened retrospectively for the presence of ECS. During EEG recording, all patients were asked to open their eyes for at least for 10s and close their eyes at the end of this period in six different montages. Hyperventilation and photic stimulation were performed according to the standard protocol of IPS.

Twenty-six patients have had ECS during EEG recording. Nineteen (73%) were women, and mean age of the patients was 24 years. The mean ages were 12.3+/-5.4 years for seizure onset and 18.5+/-4.9 years for initial detection of ECS. Eleven had a history of febrile seizures. There was a family history for epilepsy in five patients. Photosensitivity in their EEG was noticed in 11 patients. ECS was established in five epilepsy syndromes: eyelid myoclonia with absences (EMA); (n: 6), juvenile myoclonic epilepsy (JME); (n: 6), idiopathic generalized epilepsy (IGE with tonic clonic seizure); (n: 4), juvenile absence epilepsy (JAE); (n: 1) and idiopathic occipital lobe epilepsy (IOE) (n: 9). All patients were seizure free with or without anti-epileptic medication during follow up.

ECS is more common in females. It may overlap with photosensitivity but be independent from photosensitivity. It may be seen in different epilepsy syndromes including IOE which was not reported previously.