Recurrence of Epileptic Spasms as Reflex Seizures Induced by Eating: A Case Report and Literature Review

Abstract

Eating epilepsy (EE) is a rare form of reflex epilepsy in which seizures are induced by eating. It is known that most patients with eating seizures, in fact, suffer from symptomatic temporal lobe epilepsy (TLE), whereas only a few patients with epileptic spasms induced by eating (E-ES) have been reported. The patient was an 8-year-old girl whose magnetic resonance imaging (MRI) of the head detected dysgenesis of the corpus callosum, cerebellar hypogenesis, marked cerebral asymmetry, broad polymicrogyria, periventricular heterotopia, and closed lip-type schizencephaly. She experienced E-ES as the second form of recurrent seizures after the first recurrence of spontaneous ES. After E-ES occurred, the EEG findings in the right hemisphere, predominantly over the right centrotemporal region, were clearly exacerbated, although the interictal EEG originally showed left-side-dominant asymmetric hypsarrhythmia. The ictal EEG of the E-ES showed diffuse large triphasic (negative-positive-negative) potentials, predominantly over the right centrotemporoparietal region. This is a unique case because the E-ES were recurrent ES, although the previous ES were spontaneous, which may provide insight into the mechanism of E-ES.

Eight years follow-up of a generalized epilepsy patient with eating-induced late-onset epileptic spasms and atypical absence with myoclonic jerks

“…To our knowledge, this is the first case of eating induced multiple generalized seizure types including epileptic spasm, atypical absence with or without myoclonic jerks. It is generally considered that eating triggered seizures are usually related to symptomatic focal epilepsy [1,2,4].The majority of previous studies reported that the most common seizure type induced by eating is focal seizures, and almost occur in symptomatic focal epilepsy [5,6]. Based on our knowledge, this is the first case about the generalized epilepsy with eating-induced seizures, and eight years follow-up of our patient also indicates that generalized epilepsy progressed with age.…”

“…Eating epilepsy is a kind of rare reflex epilepsy, characterized by seizures closely related to eating [1]. Sei-zures induced by eating are typically focal seizures related to different underlying etiologies [2][3][4]. However, eating-induced multiple generalized seizures have not been reported yet.…”

Chewing induced reflex seizures (“eating epilepsy”) and eye closure sensitivity as a common feature in pediatric patients with SYNGAP1 mutations: Review of literature and report of 8 cases

“…An incidence of 1:1000 to 1:2000 of seizures induced by eating is reported in all epileptic patients [8,29]. Eating-induced seizures may be symptomatic or genetic and of variable semiology [30].…”

Eating Epilepsy: Pathophysiologic Models, Electroclinical Phenotypes, and Outcome

“…28 In a single case report, in which late onset epileptic spasms have been described, topiramate was beneficial. 19 Recent studies confirmed that structural epilepsies or coexistent unprovoked seizures other than ES are poor prognostic factors for pharmacological outcome. 17 Surgical treatment of epilepsy could be a good option for patients with temporal lobe epilepsy and mesial temporal sclerosis with ES.…”

“…27 Several antiepileptic drugs have been used for EE depending on the age of onset and the underlying etiology. 8,17,19,24,25 Use of sodium channel blockers in patients with mesial temporal sclerosis and valproic acid or lamotrigine in patients with negative MRI has been described. 12,17 Clobazam intake before meals was shown to be effective to prevent some cases of eatingprovoked seizures.…”