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REFLEX EPILEPSY IN CHILDHOOD
Last modified: 2014-04-03
Abstract
Reflex seizures are those, which are specifically stimulus-triggered. The prevalence among patients with epilepsy is 5%. Even when visual stimuli are known to be the most frequent precipitating factors, they can be evoked by any somatosensory stimuli.
Purpose: to report a series of pediatric patients with reflex seizures -excluding those precipitated by visual stimuli- in a pediatric patient series with reflex seizures.
Method: we reviewed the chart of 15 pediatric patients (age range between 3 months and 15 year old) that were evaluated in a pediatric neurology institute between the years 2000-2013 with video-polygraphic and EEG confirmation of reflex seizures. Triggers stimuli, clinical features, neuroimaging, seizures types, ictal and interictal electroencephalographic records and therapeutic responses were evaluated.
Results: The precipitating stimuli were: hearing 13/15, touching 7/15, proprioceptive stimuli 1/10, emotional: 1/10.
Abnormal findings in neuroimaging were found in 12 out of 15 of the patients. They presented focal tonic daily seizures with poor to no response to antiepileptic drug therapy.
Two cases with massive mioclonic jerks and no evidence of structural damage in neuroimaging, showed a favorable response to valproic acid.
Conclusion:
Reflex epilepsy provoked by any stimuli other than visual is rare in childhood. The outcome of reflex epilepsy is different regarding the presence of structural brain lesion. In case of structural brain lesion the response to antiepileptic drugs is poor.
Purpose: to report a series of pediatric patients with reflex seizures -excluding those precipitated by visual stimuli- in a pediatric patient series with reflex seizures.
Method: we reviewed the chart of 15 pediatric patients (age range between 3 months and 15 year old) that were evaluated in a pediatric neurology institute between the years 2000-2013 with video-polygraphic and EEG confirmation of reflex seizures. Triggers stimuli, clinical features, neuroimaging, seizures types, ictal and interictal electroencephalographic records and therapeutic responses were evaluated.
Results: The precipitating stimuli were: hearing 13/15, touching 7/15, proprioceptive stimuli 1/10, emotional: 1/10.
Abnormal findings in neuroimaging were found in 12 out of 15 of the patients. They presented focal tonic daily seizures with poor to no response to antiepileptic drug therapy.
Two cases with massive mioclonic jerks and no evidence of structural damage in neuroimaging, showed a favorable response to valproic acid.
Conclusion:
Reflex epilepsy provoked by any stimuli other than visual is rare in childhood. The outcome of reflex epilepsy is different regarding the presence of structural brain lesion. In case of structural brain lesion the response to antiepileptic drugs is poor.
Keywords
reflex seizures. epliepsy
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