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Abstract
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Reflex epilepsy is a type of epilepsy involving seizures that occur with sensory stimulus. It occurs when the cortical and subcortical brain areas over-react to a physiological stimulus. Stimulus can be simple like flickering lights, hot water or complex like reading and listening to music. Photosensitive epilepsy is the most common form of reflex epilepsy [1].
Photosensitive epilepsy (PSE) involves seizures caused by visual stimulation. Patients usually experience their first seizure before the age of 20. This may be a myoclonia, eyelid myoclonia, or rarely a generalized tonic-clonic seizure (GTS), occurring following a photic stimulus. Photoparoxysmal responses (PPRs) occur on these patients' EEGs with photic stimulation. PPR is defined electrographically as 2-5 Hz spike, spike wave, or slow wave complexes exhibiting frontal dominance with intermittent photic stimulation (IPS). Pathophysiology of PSE is still unclear but visual cortical hyperexcitability is the most emphasized issue [2].
In differential diagnosis of PSE; juvenile absence epilepsy, Jeavon's syndrome, childhood epilepsies with occipital paroxysms, juvenile myoclonic epilepsy and progressive myoclonic epilepsies are included [3]. All these diseases have clinical and laboratory findings with photic stimulation and can be distinguished with EEG and history of the patient.
The most common examples of stimuli that trigger PSE are televisions, computers, and mobile phones, since the high flicker, high contrast and rapidly changing patterns in these can be strong enough to precipitate seizures.
While there are interesting reports of PSE being triggered by mobile phone flashes, known as "selfie epilepsy" in the literature, firework-triggered epilepsy has not previously been reported [4]. We report the case of a young girl who experienced a seizure after watching a firework show at night and was subsequently diagnosed with PSE, with the evaluation of clinical and laboratory findings.
Case report
A 13-year-old girl presented to the emergency room due to first GTS. She described large and spectacular explosions toward the end of a firework show at a party being held in a garden on a dark night. The seizure took the form of numbness around the mouth and jerking of the upper extremities. She was unable to remember what happened after the jerks. After waking, following a brief period of confusion,
Language: en |