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PubMed2002

Eating epilepsy characterized by periodic spasms.

Seizures induced by eating are generally considered rare. Eating epilepsy is a kind of reflex epilepsy. We report two patients aged 11 and 16, with seizures provoked by eating. The eating-provoked seizures in both patients were a series of tonic spasms. Both ictal EEGs showed a periodic pattern characterized by diffuse high voltage slow wave. These findings were consistent with periodic spasms described by Gobbi et al. The ECD were widely distributed in both patients, although that of Patient 1 was partially clustered in the right frontal region. This is the first report of patients with periodic spasms induced by eating.

Adolescent↗
PubMed2001

Lorazepam: an adjuvant therapy in patients with seizure and heliotaxis.

Photosensitive epilepsy is a type of reflex epilepsy. Five percent of epileptics are photosensitive, i.e. they show photoconvulsive response (PCR) during intermittent photic stimulation. Patients with photogenic or photosensitive epilepsy have seizures with flickering light. They also exhibit heliotaxis. Sodium valproate and ethosuximide are the common drugs used. Even though benzodiazepines are useful, the specific effect of lorazepam is not mentioned. We report 5 cases of photosensitive epilepsy with inadequate response to usual antiepileptic drugs who had complete or near complete remission with lorazepam.

Adolescent↗
PubMed2006

Kindling & mossy fibre sprouting in the rat hippocampus following hot water induced hyperthermic seizures.

BACKGROUND & OBJECTIVES: Hot water epilepsy (HWE) is well recognized reflex epilepsy with possible genetic susceptibility. Rat model and human experimentation had proven that HWE is a type of hyperthermic seizure with possible kindling on repeated stimulation in animals. The present study was undertaken to investigate kindling associated with hyperthermic seizures induced by repeated hot water stimulation in the rat model and to prove hyperthermic kindling. METHODS: Epileptic seizures were induced in 36 male Wistar albino rats by means of hot water sprays at 48 h time intervals. Progression of seizure activity was investigated by studying the behaviour, severity and duration of the seizure. Threshold of rectal temperatures and timed latency for seizure induction were studied. Seizure discharges (EEG) were recorded from ventral hippocampus in six of these rats. Timm's staining was used to study the neuronal sprouting as a consequence of kindling. Studying the seizure threshold, latency, duration of seizure discharge and behavioural seizure following a stimulus-free interval of 30 days tested permanence of kindling. RESULTS: Following 8-12 episodes of hot water stimulations there was progressive epileptic activity manifested in the form of lowering of rectal temperature thresholds from 41.5 to 40.0 degrees C, drop in latency for developing seizures from 185 to 118 sec, increase in duration of hippocampal seizure discharge from 15 to 140 sec, along with progressive increase in complexity of EEG after discharges, increase in behavioural seizure severity from Grade 1 to 5 in all the rats, and neuronal sprouting observed in supragranular molecular layer and in stratum lacunosum. INTERPRETATION & CONCLUSION: Our study covered all aspects of kindling and provided a useful animal model for human hot water epilepsy. Hyperthermic seizures induced by hot water in the rat model kindle as demonstrated by Timm's staining.

Animals↗
PubMed2003

Ictal SPECT in a case of pure musicogenic epilepsy.

A 39-year-old, right-handed woman had seizures for two years which were always triggered by exposure to various types of music: the first occurred while she listened to a tune she particularly liked, Con Te Partiro, by Andrea Boccelli. Other triggering factors were various types of music such as supermarket background music and polyphonic singing or instrumental music played by family members. The seizures had a stereotyped course: she felt anxious, tearful, then occurred slight obtundation, during which she smacked her lips and moved restlessly. There was no complete loss of consciousness, but some degree of amnesia. She never experienced a generalized tonic-clonic seizure, but reported rare spontaneous feelings of déjà-vu that had begun at the same time as the induced seizures. There were no other spontaneous attacks; only one seizure was apparently provoked, not by music but by a loud background noise in her office. She was a music lover and a singer. Interictal EEG showed independent slow waves over the temporal regions. Several seizures with EEG localisation over the right temporal region were elicited after several minutes of exposure to music. Monoauricular stimulation with the same music produced a seizure when applied to the left ear but was ineffective when applied to the right ear. Ictal SPECT demonstrated right temporal hyperperfusion. MRI was normal. On high dose of carbamazepine, seizure frequency decreased. The addition of topiramate resulted in full seizure control. Musicogenic epilepsy is a rare form of reflex epilepsy. Pure cases, when patients do not experience unprovoked seizures, are exceptional. Our report confirms the implication of the right temporal lobe in this epilepsy.

Adult↗
PubMedDate not supplied

Primary reading epilepsy.

In six cases of reflex epilepsy, the seizures were triggered by reading or elaborating a verbal utterance, and were accompanied on EEG by focal or generalized epileptiform activity. The seizures were controlled with clonazepam in four cases and by sodium valproate in two cases. We speculate that the disturbance has a cortical origin and is triggered by neural processes involved in the elaboration of language.

Adult↗
PubMed1978

[About musicogenic epilepsy (author's transl)].

A case of musicogenic epilepsy or psychomotor seizures supervening whenever the patient hears a certain tune is presented. Nearly 70 cases of musicogenic epilepsy have been documented so far. The findings in these cases including those encountered by ourselves may be summarized as follows: Musicogenic epilepsy is more common among middle-aged persons. In an unexpectedly large proportion of cases the cause is unknown. Among the organic causes, head injury is of the highest incidence. It is quite unlikely that brain bumor is responsible. There is no dementia or mental retardation as in some forms of reflex epilepsy. The seizure is overwhelmingly of the psychomotor type. The EEG pattern often suggests temporal lobe epilepsy. There seems to be no cerebral dominance. Different kinds of music can be the inducer, ranging from those primarily intended to stimulate the sense to those appealing to affect. The activating mechanism of the condition still remains obscure. In the strict sense of the word, the condition cannot be termed reflex epilepsy.

Age Factors↗
PubMed2004

Hot water epilepsy - a report of three cases.

Hot water epilepsy (HWE) is a rare form of reflex epilepsy caused by bathing with hot water. In this paper, we describe three cases with hot water epilepsy. It occurs generally in children with normal psychomotor development and children continue to develop normally after seizure. HWE has usually a favorable prognosis by first avoiding lukewarm water and secondly using either intermittent oral prophylaxis with benzodiazepines or conventional AEDs.

Baths↗
PubMed1999

Familial paroxysmal kinesigenic choreoathetosis: an electrophysiologic and genotypic analysis.

PURPOSE: We report a pedigree of familial paroxysmal kinesigenic choreoathetosis (PKC) in which five of 18 members are affected. The pathophysiologic basis for PKC is still uncertain; reflex epilepsy versus dysfunction of basal ganglia. We examined (a) whether there were ictal discharges during the attacks, and (b) a linkage between PKC and possible DNA markers linked to several familial epileptic or movement disorders. METHODS: Video-monitoring EEG was performed in two patients with PKC during attacks elicited by movements of the lower extremities. Blood samples for DNA studies were obtained from 15 members of the pedigree. Fourteen polymorphic markers on chromosomes 1p, 2q, 6p, 10q, and 20q were genotyped, and two-point lod scores were calculated for each marker under a dominant model. RESULTS: No ictal discharges were found during the attacks in both patients. We could not obtain significant linkage of PKC with any marker examined. CONCLUSIONS: The video-monitoring EEG findings in our cases strongly suggested that the etiology of PKC should be considered distinct from that of reflex epilepsy. However, the patients in this pedigree had experienced generalized convulsions in their infancies; thus we could not deny the possibility of an epileptogenic basis for PKC. There was no strong evidence for a linkage of the gene for PKC with the candidate regions on 1p, 2q, 6p, 10q, or 20q.

Athetosis↗
PubMed1993

The origin of tic douloureux: a unified view.

An hypothesis on the mechanism of pain attacks in trigeminal neuralgia is presented. It is based on the analysis of clinical characteristics and pathology of a series of 278 cases submitted to different methods of treatment, and on physiological data of the literature. The hypothesis is that trigeminal neuralgia is a sort of sensory reflex epilepsy. The posterior root, damaged and distorted by a vessel or compressed by other lesions shows demyelination, micro-neuromas, and so on. At the site of this chronic damage ectopic impulses and afterdischarges are generated; the gasserian ganglion cells too give rise to spontaneous impulse generation. Owing to this chronic anomalous afferent barrage, an epileptic subliminal focus is "kindled" in the trigeminal nucleus. The pain paroxysms develop when this subliminal activity is driven in prolonged seizure discharges by peripheral (trigger zone stimulation) or other (not perceived) afferences. Clinical characteristics of the attacks (triggering by innocuous stimulations; persistence of pain after stimulus stops; diffusion of pain outside the stimulated division; refractory period after each paroxysm; increase in frequency of the attacks up to an epileptic-like status; sensibility to carbamazepine and phenytoin) and recurrence following diverse procedures are discussed on the basis of experimental research in reflex epilepsy and "kindling". If this hypothesis is true, the treatment of choice of trigeminal neuralgia should be a direct approach to the posterior fossa in order to relieve neurovascular compression which, in more than 75% of the cases, is the causative factor of the disease.

Adolescent↗
PubMed2004

Hot water epilepsy and focal malformation of the parietal cortex development.

Hot water epilepsy (HWE) refers to a specific type of reflex epilepsy precipitated by the stimulus of bathing in hot water. HWE is considered to be a geographically specific epileptic syndrome since it mainly occurs in the Indian community. Spontaneous seizures may also occur later in life. The seizure pattern includes complex partial attacks. Although the pathogenesis of HWE is still unknown, temporal lobe has been thought to take part in the epileptogenesis. This paper reports on a 4-year-old girl who, at the age of 6 months, experienced complex partial seizures triggered by bathing in hot water. Non-provoked seizures intercritical EEG showed isolated spikes and spike-and-waves in the left parietal region. Brain MRI detected a left parietal focal cortical dysplasia. This is the second patient with HWE in whom a cortical malformation has been observed. The observation present here and data reported in the literature seem to indicate that the sensory cortex might also be involved in triggering seizures precipitated by a bath in hot water. Moreover, the authors believe that MRI examination should be considered for this group of patients.

Anticonvulsants↗
PubMed1998

The Yelandur study: a community-based approach to epilepsy in rural South India--epidemiological aspects.

Data on the epidemiology of epilepsy in a rural community in a developing country would be of value in planning a decentralized management of this malady in its early stages commensurate with available local resources. A detailed screening instrument covering various seizure types was used by trained paramedical workers in a door-to-door survey of a population of 64,963 in rural South India. The prevalence period was from 1 April 1990 to 31 March 1991. The crude prevalence rate per 1000 for active epilepsy was 4.38 for males, 3.40 for females and 3.91 for both. The minimum and maximum prevalence rates, the latter computed from a validation sample, were 3.91 and 4.63 for active epilepsy; 0.28 and 0.77 for inactive epilepsy and 4.19 and 5.41 for life-time prevalence. In addition, corresponding figures for hot-water epilepsy, a type of reflex epilepsy peculiar to this area, were 2.49 and 2.99 for active phase; 0.35 and 0.85 for inactive phase and 2.85 and 3.83 for life-time prevalence. The incidence rate for epilepsy was 49.3 per 100,000, the same as in developed countries. These data do not support the concept that the prevalence of epilepsy in developing countries is twice that in the developed world. However, the role of local/regional variations should be borne in mind before extrapolating the figures to an entire country.

Adolescent↗
PubMed2001

Hot water epilepsy: clinical and electrophysiologic findings based on 21 cases.

PURPOSE: Our aim is to outline the clinical and electroencephalographic (EEG) features of patients with hot water epilepsy (HWE), a rare and unique form of reflex epilepsy. METHODS: Twenty-one patients with HWE, seen in our clinic until 1999, were studied. Male outnumbered female subjects in a ratio of 3:1. The age at the onset of seizures ranged from 19 months to 27 years (mean age at onset, 12 years). RESULTS: The main factors precipitating seizures were bathing with hot water and/or pouring water over the head. Six patients reported self-induction, either by increasing the heat or the amount of water and/or recalling earlier bathing experiences. Nine patients expressed feeling pleasure during the seizures. Twenty patients had partial seizures, eight of whom also had secondarily generalized seizures. One patient had apparent generalized seizures only. Spontaneous seizures were present in 62% of the cases. Interictal epileptogenic abnormalities were documented in the EEGs of eight patients; the other eight had normal EEGs. The major sites of epileptogenic activity were over the unilateral temporal regions (in 40% of patients). Neuroimaging studies available for 12 patients (four cranial computed tomography and eight cranial magnetic resonance imaging scans) revealed normal findings. Seizure control in patients who were followed up was achieved by reducing the temperature or the duration of the bath or shower; several of the patients required medication. CONCLUSIONS: The major findings of this study are that HWE has a male preponderance, can be self-induced, is often done for pleasure, has complex triggering factors, and shows temporally located abnormalities in the EEGs. Although HWE is generally known to be self-limited, antiepileptic drug treatment may sometimes be necessary to control seizures. Hot water epilepsy should be classified separately among the epileptic syndromes.

Adolescent↗
PubMedDate not supplied

Reflex absence epilepsy.

Epilepsy can be triggered by many unusual mechanisms. Some are exceedingly rare and bizarre, seemingly confined to one patient. This article reports the case of a 20-year-old woman who has had absence epilepsy for 11 years that is evoked by thinking or talking about driving an automobile. This stimulus consistently precipitated absence seizures, as defined by clinical and electroencephalographic criteria. An emotionally traumatic early childhood event may play a role in the triggering mechanism. A similar case has not been reported.

Adult↗