Photosensitive Epilepsy Syndromes Mimicking Motor Tics

Longardner, Katherine; Desai, Soaham; Nespeca, Mark; Bainbridge, Matthew N.; Friedman, Jennifer

doi:10.1002/mdc3.13053

Cited by 2 publications

(3 citation statements)

References 22 publications

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“…Tics are repetitive not rhythmic movements, they may change over time, they are often preceded by an unpleasant sensation of “urgency to do”. They occur intermittently and can, to some degree, be suppressed by effort of will ( 8 ). This sets them apart from the gaze impersistence of chorea, the incessant, multi-directional eye “dancing” of opsoclonus, dystonic oculogyric crises and from tonic or clonic eye or eyelid movements of seizures ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

“…Concerning epilepsy, blinking may be part of very brief seizures apparently only involving the eyes with rapid tic-like movements that can be misleading for diagnosis. Particularly, blinking may be observed in eyelid myoclonia which is an ictal phenomenon characterized by rapid, jerky blinking immediately after eye closure associated with mild upward gaze deviation ( 8 ). Eyelid myoclonia can be differentiated from tics by the rapid frequency of blinking, transient unresponsiveness, and photosensitivity.…”

Section: Discussionmentioning

confidence: 99%

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Case report: A relevant misdiagnosis: Photosensitive epilepsy mimicking a blinking tic

Burlo

Barbi²,

Carrozzi³

et al. 2022

Front. Pediatr.

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Blinking in children is most frequently a functional and transient symptom. Nonetheless, sometimes it is the first clinical manifestation of a neurological disorder. The differential diagnosis between voluntary actions, tics and other neurological disorders among which seizures may be challenging and misdiagnosis is common. A 6-year-old girl in good health was admitted for a recent history of bilateral eye blinking. Blinking did not interfere with the girl's activities. The patients reported that blinking seemed to be triggered by sunlight exposure and that girl sometimes seemed to be attracted by the sunlight. Ophthalmological diseases had been already excluded. The girl was addressed to our hospital for neurological consultation, as tic disease was considered the most probable hypothesis. Neurological examination was negative. In the field of differential diagnosis of photosensitive abnormal eyelid movements, the hypothesis of seizures was explored and further investigated with a video-EEG recording with light stimulation. This exam demonstrated a photoparoxysmal response (PPR) to intermittent photic stimulation with appearance on EEG of bilateral spike and polyspike waves associated with eyelid jerks. This girl suffers from generalized epilepsy with photosensitivity. Photosensitivity is a common feature of many epilepsy syndromes, mainly occurring in children and adolescents. To control the seizures, it is essential to avoid the triggering stimulus, by wearing specific glasses. Additional antiseizures treatment is often necessary, at first with valproate and levetiracetam, and ethosuximide, lamotrigine, and benzodiazepines as the second choice. Overlapping phenomenology of seizures and movement disorders is well known in paediatric clinical practice. Moreover, epilepsy and movement disorder may coexist, mainly in children. Seizures with semeiology limited to eye motor manifestations may mimic functional blinking, tics, and other motor events frequently observed in childhood. Differentiating seizures from other non-epileptic paroxysmal movements may be challenging and specialist evaluation is needed for proper treatment and prognostic counselling.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case report: A relevant misdiagnosis: Photosensitive epilepsy mimicking a blinking tic

Burlo

Barbi²,

Carrozzi³

et al. 2022

Front. Pediatr.

View full text Add to dashboard Cite

show abstract

“…Therefore brain MRI or laboratory tests, including copper studies, represent very low-yield investigations. Other investigations that appear to be used disproportionately for their clinical need include neurophysiology, as for example EEG, which in rare cases may be helpful particularly where overlapping phenomena of different etiologies are suspected [11]. Finally, about one-third of respondents measure Group A Streptococcus antibody (GAS) titers, likely to screen for PANS/PANDAS.…”

Section: Discussionmentioning

confidence: 99%

Clinical Practice Patterns in Tic Disorders Among Movement Disorder Society Members

Ganos

Sarva

Kurvits

et al. 2021

Tremor and Other Hyperkinetic Movements

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Photosensitive Epilepsy Syndromes Mimicking Motor Tics

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Cited by 2 publications

References 22 publications

Case report: A relevant misdiagnosis: Photosensitive epilepsy mimicking a blinking tic

Case report: A relevant misdiagnosis: Photosensitive epilepsy mimicking a blinking tic

Clinical Practice Patterns in Tic Disorders Among Movement Disorder Society Members

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