Self-induction of seizures in photosensitive patients in a tropical country

Two Sri Lankan girls who, in their childhood, developed self-induced epilepsy are reported. The seizures were tonic-clonic and induced by rubbing the forehead in one case and by waving one hand in front of the eyes in the other. These manoeuvres performed while gazing at a bright light evoked generalised polyspike and wave discharges. The patients had no explanation for their behaviour but the most likely basis for the act was attention-seeking. One patient whose seizures were not controlled with phenytoin received clobazam as adjuvant therapy and showed a marked improvement clinically and electroencephalographically.