[Reflex epilepsy evoked by decision making: report of a case (author's transl)]

A 17-year-old girl with a story of Gran Mal attacks occurring during lessons of mathematics or solving mathematical problems, was investigated with prolonged EEG recordings. During the sessions, relax periods were alternated with arithmetical or mathematical testing, with card or checkers games and solution of puzzles and crossword problems, and with different neuropsychological tests. EGG recordings were characterized by the appearance, on a normal background, of bilaterally synchronous and symmetrical spike-and-wave and polispike-and-wave discharges, associated with loss of consciousness. During relax their mean frequency was one/54 min., it doubled during execution of tests involved with nonsequential decision making, and was eight times as high (one/7 min.) during tests involving sequential decision making. Some tension, challenge and complexity of the performance were also important as precipitating factors. Their lack deprived sequential tests of their efficacy, while on the contrary their presence sometimes gave nonsequential tests full efficacy.