Unusual form of seizures induced by eye closure

Seizures induced by eye closure are a rare but well-recognized form of reflex epilepsy. Two types have been reported: those induced by movement of the eyelids and those caused by lack of visual input. The EEG pattern is typically that of spike and wave discharges, either isolated to the occipital regions or greatest there. We report the case of a 19-year-old woman with a previously undescribed form of seizures induced by eye closure in whom both the physical act of eye closure and total lack of visual input were required for induction of a seizure. Both the EEG pattern of paroxysmal high-amplitude generalized beta activity and poor response to medication were different from what has been previously noted in patients with seizures induced by eye closure. We believe that a third form of seizures induced by eye closure exists and that its prognosis may be significantly worse than that of previously reported forms.