Letter to the EditorEye closure sensitivity and catamenial nonconvulsive status epilepticus – A case report
Introduction
Eye closure sensitivity (ECS) is a phenomenon in which eye closure induces temporary (usually generalized) epileptiform discharges on the EEG, usually lasting 1–4 s. It has been reported that ECS may be common to several epilepsy syndromes, such as eyelid myoclonia with absences, juvenile myoclonic epilepsy, idiopathic generalized epilepsy, childhood and juvenile absence epilepsy, and idiopathic occipital lobe epilepsy (Sevgi et al., 2007). At the same time ECS should be differentiated from fixation-off sensitivity. In fixation-off sensitivity the epileptiform discharges (with occipital localization) occur by the elimination of central vision and/or fixation. The epileptiform discharges are present when eyes are closed or when fixation is prevented (e.g. with Frenzel-glasses) and they are not specifically related to eye closure.
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Case description
We present a 44-year-old woman of normal intelligence who was diagnosed with idiopathic generalized epilepsy with absences at the age of 9 years. From the age of 7 years, her mother described frequent episodes which lasted about 1 h in which she rolled and blinked her eyes frequently, and was slow but reactive during this period. A diagnostic EEG reported a mild diffuse cerebral disturbance with an abundance of spike wave activity. No physical record of that EEG could be obtained at the time of
Clinical relevance
To our knowledge this is the first case described in a patient diagnosed with idiopathic generalized epilepsy with eye closure sensitivity and atypical catamenial nonconvulsive status epilepticus. It has previously been reported that patients with ECS often result to self-induction behavior by means of repeated eye rolling (deep retroflexion) combined with rapid eyelid flicker movement. Such behavior could be attributed to experiencing a pleasurable sensation, to relieve stress or to gain
Conflict of interest
None.
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