Seizures triggered by eating - A rare form of reflex epilepsy: A systematic review

Girges, Christine; Vijiaratnam, Nirosen; Wirth, Thomas; Tjoakarfa, Clarissa; Idaszak, Jacqueline; Seneviratne, Udaya

doi:10.1016/j.seizure.2020.09.013

Cited by 18 publications

(29 citation statements)

References 70 publications

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“…Eating can be reported as the only provoking factor or mixed with others, as eating-induced seizures are usually associated with symptomatic epilepsies [ 4 ]. Seizures can occur in the early phase of eating (generally within the first 5 min) or in the middle or end of meal [ 6 ]. Focal seizures with impaired responsiveness are the commonest seizure type followed by focal seizures without impaired responsiveness and with secondary generalization [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Seizures can occur in the early phase of eating (generally within the first 5 min) or in the middle or end of meal [ 6 ]. Focal seizures with impaired responsiveness are the commonest seizure type followed by focal seizures without impaired responsiveness and with secondary generalization [ 6 ]. Seizures usually arise in temporal-limbic or extra-temporal perisylvian regions and may progress to secondary generalization.…”

Section: Discussionmentioning

confidence: 99%

“…The emotional or autonomic components of eating, along with gastric distension or stimulation of the mouth or pharynx, may also play an important role in inducing seizures [ 22 – 24 ]. Monotherapy or polytherapy were used; the most effective treatments reported were sodium valproate, carbamazepine, clobazam and phenobarbital [ 6 ]. Monotherapy with carbamazepine likely offers the best seizure control in focal seizures [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Besides, the observation of familial eating epilepsy supports the hypothesis of a genetic aetiology [ 1 , 5 ]. In EE, the ictal semiology mostly consists of focal seizures with or without secondary generalization [ 6 ]. Monotherapy or combination therapy is generally necessary.…”

Section: Introductionmentioning

confidence: 99%

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Symptomatic eating epilepsy: two novel pediatric patients and review of literature

et al. 2021

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Eating epilepsy (EE) is a form of reflex epilepsy in which seizures are triggered by eating. It is a rare condition but a high prevalence has been reported in Sri Lanka. In EE, the ictal semiology includes focal seizures with or without secondary generalization or generalized seizures. Some cases are idiopathic while focal structural changes on imaging, if present, are often confined to the temporal lobe or perisylvian region. On the other hand, some cases support the hypothesis of a genetic aetiology. The prognosis of EE is extremely variable due to the different nature of the underlying disorder. We describe two patients with symptomatic eating epilepsy, a 13-year-old boy with a bilateral perisylvian polymicrogyria and a 2-year-old boy with a genetic cause. The presence of structural lesions or the dysfunction of specific cortical regions in the context of a germline genetic alteration might lead to a hyperexcitation fostering the epileptogenesis. We review the available literature to clarify the aetiopathogenesis and the mechanisms underlying EE to improve the diagnosis and the management of these rare conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Symptomatic eating epilepsy: two novel pediatric patients and review of literature

et al. 2021

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“…However, the instruction manual accompanying the new classifications do mention RE and leave room for its continued promulgation [7]. Therefore, under the current ILAE classification, RS receive the same emphasis as spontaneous seizures in an epilepsy diagnosis [8].…”

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confidence: 99%

Reflex Epilepsy

Hanif¹,

Musick²

2021

Aging and disease

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Reflex seizures (RS) are epileptic events that are objectively and consistently elicited in response to a specific afferent stimulus or by an activity of the patient. The specific stimulus can be a variety of heterogenous intrinsic or extrinsic factors, ranging from the simple to the complex, such as flashing lights or reading a book. These seizures can take a variety of forms, comprising either general or focal onset, with or without secondary generalization. Reflex epilepsies (RE) are classified as a specific syndrome in which all epileptic seizures are precipitated by sensory stimuli. The few designated RE include idiopathic photosensitive occipital lobe epilepsy, other visual sensitive epilepsies, primary reading epilepsy, and startle epilepsy. RS that occurs within other focal or generalized epilepsy syndromes that are associated with distinct spontaneous seizures are classified by the overarching seizure type. Most patients experience spontaneous seizures along with their provoked events. RS originate from stimulation of functional anatomic networks normally functioning for physiological activities, that overlap or coincide with regions of cortical hyperexcitability. Generalized RS typically occur within the setting of IGEs and should be considered as focal seizures with quick secondary generalization via cortico-cortical or cortico-reticular pathways. In aggregate, activation of a critical neuronal mass, supported and sustained by cortico-subcortical and thalamocortical pathways eventually result in a seizure. Treatment includes antiseizure medication, commonly valproate or levetiracetam, along with lifestyle modifications, and when amenable, surgical intervention. High clinical suspicion and careful history taking must be employed in all epilepsy patients to identify reflex triggers.

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Eating‐induced seizures: A semiological sign of the right temporal pole

Tena‐Cucala,

Sala‐Padró,

Jaraba

et al. 2023

Epileptic Disorders

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ObjectiveEating‐induced seizures (EIS) are a rare form of reflex seizures. The objective of this study was to report a series of cases of EIS involving patients admitted to our epilepsy unit, and to analyze the clinical characteristics, etiology, and treatment response of this type of infrequent seizure.MethodsWe performed a single‐center retrospective analysis of all consecutive patients diagnosed with epilepsy with eating‐induced seizures between 2008 and 2020.ResultsWe included eight patients (six women) with mean age 54.75 years (range: 40–79), and mean age at epilepsy onset 30.75 years (range: 9–58 years). EIS were triggered during a meal in 5/8 (at dinner 1/8, at breakfast in 1/8, and without time preference in 3/8), by a certain flavor in 1/8, by eating different textures or drinking soft drinks in 1/8, and by slicing food in 1/8. All patients suffered nonreflex seizures and 3/8 other types of reflex seizures. In 6/8 of patients, EIS originated in the right hemisphere. In 5/8, the EIS progressed to impaired awareness with oromandibular automatisms. In 6/8, the epilepsy was drug‐resistant. Temporopolar encephalocele was the most frequent etiology, in 4/8. Three of the eight underwent surgical treatment, with Engel IA 1 year in 3/3. Three of the eight were treated with vagal stimulation therapy, with McHugh A 1 year in 2/3.SignificanceIn our series, eating‐induced seizures were observed in patients with focal epilepsy. It was frequently drug‐resistant and started predominantly in the right hemisphere, due to temporal pole involvement in half of the patients.

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Seizures triggered by eating - A rare form of reflex epilepsy: A systematic review

Cited by 18 publications

References 70 publications

Symptomatic eating epilepsy: two novel pediatric patients and review of literature

Symptomatic eating epilepsy: two novel pediatric patients and review of literature

Reflex Epilepsy

Eating‐induced seizures: A semiological sign of the right temporal pole

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