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Epileptic discharges triggered by blinking and eye closure
Insights
Eye closure and blinking triggered EEG discharges in two children, suggesting muscle contraction may be an epileptic trigger. These findings were observed in both light and darkness.
Area of Science:
- Neurology
- Pediatric Neurology
- Clinical Neurophysiology
Background:
- Epilepsy in children can present with various seizure triggers.
- Understanding specific triggers like eye movements is crucial for diagnosis and management.
Observation:
- Two pediatric cases exhibited electroencephalogram (EEG) discharges specifically linked to eye blinking and/or eye closure.
- These discharges occurred irrespective of ambient light conditions (light and darkness).
Findings:
- Case 1 showed focal posterior EEG discharges with eye blinks and repetitive focal posterior sharp waves with eye closure, without photoparoxysmal responses.
- Case 2 presented with generalized epileptic discharges and photoconvulsive responses triggered by eye closure, sometimes associated with clinical seizures.
- The consistent triggering by eye closure/blinking in varied light suggests a potential role for sensory afferents from orbicularis oculi muscle contraction.
Implications:
- Sensory afferents from orbicularis oculi muscle contraction may act as an epileptic trigger in susceptible individuals.
- This highlights the importance of considering non-photogenic triggers, such as eye movements, in pediatric epilepsy evaluations.
- Further research into somatosensory-evoked seizures could refine diagnostic and therapeutic strategies.
Abstract:
Two children manifested EEG discharges which were triggered by blinking and/or eye closure in light and in darkness. The first case demonstrated single focal posterior discharges with eye blinks and repetitive focal posterior sharp wave discharges with eye closures. No photoparoxysmal responses were obtainable. Case 2 manifested generalized epileptic discharges triggered by eye closure which were sometimes associated with clinical seizures. In addition she showed photoconvulsive responses. Since the discharges triggered by eye blink and by eye closure occurred in both bright light and in darkness it is suggested that sensory afferents arising from contraction of the orbicularis oculi muscles may have been the epileptic trigger in Case 1 and could have contributed to the epileptic triggering mechanism in Case 2.