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[A case of reflex epilepsy with binasal visual field defects attack induced by family computer game].

A 12-year-old male case of reflex epilepsy with visual field defects attack induced by a family computer game was reported. This patient showed binasal visual field defects attack when he was playing a family computer game. Neurological findings and ophthalmological examinations were normal. EEG showed spike and slow wave complex distributed on right occipital region. These paroxysmal waves were activated by checkerboard pattern reversal stimuli. Stimulus intensity was closely related with these activations, but not stimulus ratio was. Examinations of brain CT and brain MRI were normal. This patient complained of discomfort without visual symptoms when he suffered checkerboard pattern stimuli. A family computer game needs mental concentration, recognition, decision, alert state of consciousness and complex finger movement. Integration of these factors may have induced visual field defects attack. It is interesting that a family computer game is the inducer of reflex epilepsy with visual symptoms. The number of reflex epilepsy is thought to increase because of prevalence of family computer games.

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An avian model of genetic reflex epilepsy.

The Fayoumi strain of chickens (Fepi) carries a recessive autosomal gene mutation in which homozygotes are afflicted with a photogenic and audiogenic reflex epilepsy. Seizures consist of stimulus-locked motor symptoms followed by generalized self sustained convulsions. EEG recordings show spikes and spike and waves patterns at rest which are suppressed during seizures and replaced by a desynchronized pattern of activity. Neurones of the prosencephalon discharge in bursts at rest, while neurones of the mesencephalon are bursting during seizures. Living neural chimeras were obtained by replacing specific embryonic brain vesicles in a normal chicken embryo with equivalent vesicles from a Fepi donor. These chimeras show that the epileptic phenotype can be totally or partially transferred from the Fepi to the normal chickens. Total transfer of photogenic and audiogenic seizures was obtained by substitution of both the prosencephalon and mesencephalon, while substitution of the prosencephalon alone resulted in transfer of interictal paroxysmal activity and substitution of the mesencephalon alone resulted principally in transfer of ictal motor symptoms. Increased expression of the c-fos protooncogene, as revealed by the western blot technique, confirmed the distinct encephalic localizations of the symptoms of the photogenic and audiogenic reflex epilepsy of the Fepi shown with the methods of electrophysiology and brain chimeras. We conclude that the Fepi is a good model of brain stem reflex epilepsy and suggest that the brain stem is a generator of some other animal and human genetic reflex "epileptic syndromes".

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