Generalized seizure with falling and unresponsive staring provoked by somatosensory stimulation: a video-EEG study

We report a 4-year-old boy with generalized seizures with abrupt falling and unresponsive staring provoked by somatosensory stimuli of the face. Ictal manifestation comprised a sudden fall immediately after wiping the face, followed by unresponsive staring for around 10 seconds, during which time the video-EEG recorded paroxysmal 3-Hz diffuse spike-wave complexes, which were followed by high-voltage 3.5 to 4-Hz delta wave discharges, predominantly appearing in the bilateral frontal areas. Seizures were not controlled by clonazepam, valproate or levetiracetam, but were successfully treated with lamotrigine added to valproate. This type of generalized reflex seizure has so far not been reported in the literature. [Published with video sequence].