Photosensitivity and epilepsy: Current concepts and perspectives-A narrative review

Area of Science:

• Neurology
• Epilepsy Research
• Neuroscience

Background:

• Photic stimuli have been linked to epileptic seizures since the 1950s.
• Increased exposure to flickering displays in modern life has renewed interest in photosensitive epilepsy (PSE).
• Approximately 5% of epilepsy patients have PSE, which is more common in young women and often linked to Juvenile Myoclonic Epilepsy (JME).

Purpose of the Study:

• To review the influence of photic stimuli on epileptic seizure generation.
• To explore the history, characteristics, and underlying mechanisms of photosensitive epilepsy.
• To discuss preventive measures for photosensitive epilepsy.

Main Methods:

• Review of existing literature on photic stimuli and epilepsy.
• Analysis of structural and functional studies in photosensitive epilepsy.
• Discussion of genetic and ethnic factors influencing photosensitive epilepsy.

Main Results:

• Diverse stimulation parameters (frequency, color, lighting) affect seizure generation.
• Structural and functional brain abnormalities, particularly involving the visual cortex and frontopolar regions, are implicated in PSE.
• Hypothesized role of the striato-thalamocortical system in photoparoxysmal responses (PPR) as a feature of JME.

Conclusions:

• Photosensitive epilepsy is a distinct epilepsy syndrome with specific neurobiological underpinnings.
• Understanding brain connectivity changes may explain seizure triggers in JME.
• Preventive strategies are crucial, and drug treatment requires careful consideration of risks and benefits for affected demographics.