Seizures triggered by eating - A rare form of reflex epilepsy: A systematic review

Eating epilepsy is a rare disorder, characterised by reflex seizures induced by food intake. It is highly heterogenous, with clinical signs and EEG findings varying between patients. However, common features do emerge from the reported literature. The aim of this systematic review was to bring together this information to facilitate understanding and recognition. We therefore searched electronic databases (PubMed, Scopus, Medline) for relevant studies using keywords 'epilepsy', 'seizure' and 'eating' in March 2020. Human studies, written in English, that reported on cohorts of patients with eating epilepsy were included. Fifty-two unique papers were consequently identified, describing seizure characteristics and diagnostic features in 378 patients. Eating seizures began in the second decade of life, with a higher incidence in males. They were typically focal-onset, and most commonly of the focal impaired awareness type. Pharmacological therapy with one or multiple agents was noted in 80 % of cases, with poor control reported in approximately 25 % of patients. While this retrospective work highlights key features, it is important that future studies implicate video EEG to fully evaluate this highly unique and interesting disorder.