Eating Epilepsy Characterized by Periodic Spasms

Abstract

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.

Stimulus-induced reflex epileptic spasms in 5p− syndrome

“…Distribution of interictal negative spikes and ictal positive waves in the same areas is common to the epileptic spasms in general, the mechanism for the change in polarity remains unclear. Stimulus-induced epileptic spasms are rare even among reflex epilepsies; we found several cases in which spasms were triggered by a somatosensory stimulus [3,4], or by eating [2,5,6,13]. Ictal EEG findings are often described as diffuse high-voltage slow waves; however, some cases presented ictal slow waves with a frontocentral [5], temporal [6] or occipital [4] predominance.…”

“…Stimulus-induced epileptic spasms are rare even among reflex epilepsies; we found several cases in which spasms were triggered by a somatosensory stimulus [3,4], or by eating [2,5,6,13]. Ictal EEG findings are often described as diffuse high-voltage slow waves; however, some cases presented ictal slow waves with a frontocentral [5], temporal [6] or occipital [4] predominance. It is interesting that the ictal positive slow waves at Fp1/Fp2 and T4 areas on rare occasions in patient 1; these may suggest that the eating-induced cortical activation may propagate to other excitable areas from the initially activated T3 area, which then trigger the spasms.…”

“…Reflex spasm is a reflex seizure in which somatosensory stimulus from the trigeminal area or the extremities acts as specific trigger to provoke epileptic spasms [3,4]. Eating behaviour can elicit reflex spasms in rare occasions [5,6]. Herein we delineate seizure semiology and ictal EEG findings in two patients, and discuss the pathophysiology and significance of this epileptic phenomenon in 5pÀ syndrome.…”

Eating Seizure; Case Report

“…Bunların arasında ileri yaşta ortaya çıkan periodik spazm ve EEG'de hipsaritminin olduğu YYE tanımlanmıştır. [5,7] Bizim olgumuz- Hastaların %50-70'inde nöbetlerin monoterapi ile kontrol edildiği raporlanmıştır. Olgumuza tanı konduktan sonra KBZ başlanmış 1000 mg/gün çıkıldığında doza bağlı toksik bulgular (diplopi) belirlendiği için tedavi 800 mg/gün ile sınırlandırılarak, ikinci antiepileptik sağaltım (levetirasetam 1000 mg/gün) başlandı.…”

Neonatal Eating Epilepsy: Pathophysiological and Pharmacologic Aspects

“…In patients with suprasylvian lesions, the seizures are prevalently induced by proprioceptive or somatosensory stimuli (8). The anteromedial temporal lobe, the amigdala in particular, is probably implicated in the eating seizures epileptogenesis (2)(3)(8)(9)(10). The mechanism for reflex seizures in EE still remains unknown (8).…”