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At least 19 recordsLinked to original sources
PubMed2006

Reflex seizures and reflex epilepsy.

Reflex seizures are evoked by a specific afferent stimulus or by activity of the patient and are divided into those characterized by generalized seizures and those principally manifested by focal seizures. Reflex epilepsies are syndromes in which all epileptic seizures are precipitated by sensory stimuli. Three categories of reflex seizures encountered clinically include pure reflex epilepsies, reflex seizures that occur in generalized or focal epilepsy syndromes that are also associated with spontaneous seizures, and isolated reflex seizures occurring in situations that do not necessarily require a diagnosis of epilepsy. Generalized reflex seizures are precipitated by visual light stimulation, thinking, and decision making. These seizures usually respond to valproate treatment. Numerous triggers can induce focal reflex seizures. The triggers include reading, writing, other language functions, startle, somatosensory stimulation, proprioception, auditory stimuli, immersion in hot water, eating, and vestibular stimulation. The classification and characteristics of reflex seizures and epilepsies are described in this review. Findings on EEG and advanced neuroimaging in the reflex seizures and epilepsies, treatment and preventive options, and animal models and mechanisms are also discussed.

Animals↗
PubMed2000

Reflex epilepsy and reflex seizures of the visual system: a clinical review.

Reflex epilepsy of the visual system is charecterised by seizures precipitated by visual stimuli. EEG responses to intermittent photic stimulation depend on the age and sex of the subject and on how stimulation is performed: abnormalities are commonest in children and adolescents, especially girls. Only generalised paroxysmal epileptiform discharges are clearly linked to epilepsy. Abnormal responses may occur in asymptomatic subjects, especially children. Photosensitivity has an important genetic component. Some patients are sensitive to patterns, suggesting an occipital trigger for these events. Myoclonus and generalised convulsive and nonconvulsive seizures may be triggered by visual stimuli. Partial seizures occur less often and can be confused with migraine. Although usually idiopathic, photosensitive epilepsy may occur in degenerative diseases and some patients with photosensitive partial seizures have brain lesions. Sunlight and video screens, including television, video games, and computer displays, are the commonest environmental triggers of photosensitive seizures. Outbreaks of triggered seizures have occurred when certain flashing or patterned images have been broadcast. There are regulations to prevent this in some countries only. Pure photosensitive epilepsy has a good prognosis. There is a role for treatment with and without antiepileptic drugs, but photosensitivity usually does not disappear spontaneously, and then typically in the third decade.

Adolescent↗
PubMed2005

Mah-Jong-induced epilepsy: a special reflex epilepsy in Chinese society.

We present five patients of epilepsy in which seizures were triggered by playing or watching the traditional Chinese gambling game "Mah-Jong." One patient also experienced seizures while playing a computer version of the Mah-Jong game. This condition appeared to have a predominance of males (80%) and middle-aged onset (39.4 years). Four patients had generalized tonic-clonic seizures and one patient had partial seizures with secondary generalization. No spontaneous seizure occurred in these patients. Three patients had been receiving antiepileptic drug therapy, but without effective control over their seizures. Mah-Jong-induced epilepsy is a very peculiar form of complex reflex epilepsy that involves the higher mental activities. This phenomenon may consist of distinct pathophysiologic mechanisms from other reflex epilepsy induced by thinking and spatial tasks in idiopathic generalized epilepsies. This unusual reflex epilepsy is relatively benign in nature and antiepileptic drug therapy has uncertain benefits. It may be necessary to avoid playing the Mah-Jong game in order to prevent seizures.

Adult↗
PubMed2000

Mah-jong epilepsy: a new reflex epilepsy.

BACKGROUND: Flickering light and color patterns, reading, language, movement, decision making, eating, tapping and touching, hot water immersion and auditory stimulation can induce seizures in some patients. This is known as "reflex epilepsy". The mechanism of reflex epilepsy is not clear. Recently, we cared for 12 patients (11 men and 1 woman, age 41-74 years; mean age = 63.1 years) whose seizures were induced by playing mah-jong, with mean age at seizure onset of 48.7 years. Nine of the 12 patients had seizures exclusively while playing mah-jong. METHODS: We retrospectively reviewed the medical records of 12 epileptic patients who visited our neurologic clinic from 1987 to 1999, with the chief complaint of mah-jong induced seizures. All patients underwent examinations including electroencephalography, brain computed tomography or magnetic resonance imaging, analysis of clinical manifestation of seizures, family history and past medical history. All were given anticonvulsant therapy for preventing seizures. RESULTS: Clinically, 10 patients had generalized tonic-clonic seizures and two patients had partial seizures with secondary generalization. Interictally, normal results on EEG were found in six patients, three had focal temporal spikes, and three had intermittent slow activity in the frontotemporal regions. Neuroimaging studies of the brain were normal in seven patients, two had lacunar infarctions, one had generalized atrophy and one had focal left parietal lesions of an unclear nature. Only one patient had a family history of epilepsy. All 12 patients received anticonvulsant therapy, and of these, nine had good epilepsy control. CONCLUSIONS: "Mah-jong epilepsy," a new reflex epilepsy, is probably related to thinking and decision making while playing mah-jong. The easy control of seizures induced by mah-jong suggests a benign nature. In addition to anticonvulsant therapy, avoiding playing mah-jong may be essential in preventing seizures.

Adult↗
PubMed2001

Rub epilepsy: a somatosensory evoked reflex epilepsy induced by prolonged cutaneous stimulation.

To delineate rub epilepsy--a type of reflex epilepsy induced by prolonged or repetitive cutaneous stimulation in a circumscribed area of the body--three cases are presented, as well as one of tooth brushing epilepsy for comparison. In all three cases of rub epilepsy, cutaneous stimuli in a particular body area on the left side initially induced a sensory jacksonian march in the middle of, or in close vicinity to, the trigger zone, which led to subsequent unilateral tonic contractions with intact consciousness. By contrast, a motor jacksonian seizure without sensory aura was induced in the patient with tooth brushing epilepsy. A review of cases with rub epilepsy, including those in this paper, disclosed a striking consistency in clinical manifestations. The symptomatology of the induced seizures indicates a propagation of epileptic discharges from the postcentral gyrus to the supplementary motor area. Rub epilepsy is proposed as a separate clinical entity, clearly demarcated from other somatosensory evoked reflex epilepsies such as startle and tooth brushing epilepsy.

Adult↗
PubMed2000

[Reflex epilepsies].

INTRODUCTION: Reflex seizures are provoked by a specific sensory stimulus. Approximately 6% of all epileptic patients have reflex seizures. For identification of these seizures it is necessary to take a directed history and make an EEG study whilst the patient is being exposed to the stimulus, which will confirm the diagnosis. DEVELOPMENT: Many stimuli are effective in provoking reflex seizures, the commonest are visual. Amongst the various epileptic syndromes there are different types of epilepsies with reflex seizures which generally correspond to idiopathic generalized epilepsies. The physiopathogenic mechanisms are usually complex. The cerebral cortex corresponding to the function which induces the epileptic crisis is hyperexcitable, and is the cause of an identifiable lesion or dysfunction without an underlying lesion. CONCLUSION: The diagnostic importance of reflex seizures is that when some formerly drug-resistant patients can control the mechanism which triggers off their seizures they attain good control of them.

Brain↗
PubMedDate not supplied

Hot-water epilepsy: a variant of reflex epilepsy in southern India.

"Hot water epilepsy" (HWE), precipitated by a bath or shower in hot water, has been described infrequently in the literature. We report 279 cases of HWE that were seen between 1980 to 1983 in Bangalore, South India. We found HWE to be more common in children, with cases more frequent among male than female patients (2.6:1). Complex partial seizures constituted the main clinical presentation (67.0%); HWE accounted for 4.4% of all complex partial seizures and generalize tonic-clonic seizures seen at our center during the 1980-1983 period. Although prognosis seems favorable 25.4% of our patients developed nonreflex epilepsy within 1-3 years. They were managed with antiepileptic drugs and the use of lukewarm water for bathing.

Adolescent↗
PubMed2005

Reflex epilepsies; clinical and demographic characteristics in a tropical country.

BACKGROUND: This study is aimed at defining the clinical spectrum and demographic aspects of reflex epilepsy in a tropical country in Asia. METHODS: We studied 526 consecutive patients with epilepsy. Details of seizure provoking factors were obtained from direct interviews and medical records. RESULTS: Of the 526 patients, 47(8.9%) were found to be having reflex epilepsy. There were 25(53.2%) males and 22(46.8%) females. Family history of epilepsy and reflex epilepsy were found in 8(17%) and 3(6.4%) respectively. Provoking factors were, eating (34%), higher cerebral functions (17%), bathing (10.6%), photosensitivity (8.5%), startle induced (4.3%), and mixed (more than one of the above: 25.5%). Seizures were provoked by above factors, exclusively in 10 (21.3%), mostly (more than 50% occasions) in 10 (21.3%), and sometimes (less than 50% occasions) in 27 (57.4%) patients. The type of seizure was complex partial evolving to generalized in 23 (48.9%), complex partial in 10 (21.3%), and generalized in 14 (29.8%). CONCLUSION: Our study highlights geographical differences in the spectrum of reflex epilepsy.

Adolescent↗
PubMed1992

Reflex epilepsy.

We report 3 cases of reflex epilepsy, 2 of them triggered by reading (reading epilepsy) and one by mathematical calculation (epilepsy arithmetics). Electroencephalographic abnormalities predominated in the dominant hemisphere. The pathophysiologic mechanisms involved in this rare form of epilepsy are commented on, particularly the role played by the association of mental concentration and emotional strain. A possible deficiency in GABA-ergic inhibitory synapses would cause a deficit in cortical inhibition. Different drugs have been used successfully in patients with reflex epilepsy. Psychotherapy relieves anxiety and has been shown to be an effective complement to medical treatment.

Adolescent↗