A study of 63 cases with eyelid myoclonia with or without absences: Type of seizure or an epileptic syndrome?

Abstract

In the first group, EMA should be considered as a photosensitive idiopathic epileptic syndrome. A subgroup of early-onset of EMA refractory to AEDs, associated or not with GTCS and mental retardation should also be considered as a variant or a distinct photosensitive idiopathic epileptic syndrome. Finally, in the second group EMA may correspond to a type of seizures in idiopathic generalized epilepsies.

Eyelid myoclonia seizures in adults: An alternate look at the syndrome paradox

“…A family history of epilepsy with varying degrees of familiarity was present in 55% of these patients with pure EMA, which was similar to prior reports [8,17,20,[48][49][50]. Fifteen (50%) patients had mental problems ranging from learning difficulties and memory impairment to mental retardation, as shown previously in literature [3,6,16,33,51].…”

“…These outcomes support the importance of video-EEG recordings in the avoidance of misdiagnosis [8,25,34].…”

“…The diagnosis in patients with pure EMA was fairly delayed (mean: 10.3 years). Despite prior knowledge on EM characteristics such as 'if it is seen once, eyelid myoclonia will never be forgotten' [16] and 'when EM is combined with photosensitivity and it's pathognomonic of the syndrome when it also occurs after eye closure' [8], our findings show that the diagnosis of EMA is difficult and complicated, especially in adult life, due to various reasons including the following:…”

“…It is possible that long-lasting EEG abnormalities and treatment with inappropriate AEDs may play a role in developing mental impairment. These patients may be considered as a subgroup among patients with EMA [8,51,52].…”

“…Although EMA is considered well defined with its clinical and electrophysiological features described by several authors [3][4][5][6][7][8][9][10][11], its place in the epilepsy classifications is still debated. Even in the latest ILAE (International League Against Epilepsy) classifications, EMA has been listed as a type of seizure [12][13][14].…”