Self induced noogenic seizures in a photosensitive patient
- Department of Clinical Neurophysiology and Epilepsies, St Thomas’ Hospital, Lambeth Palace Road, London SE1 7EH, UK
- Dr M Koutroumanidis, Department of Clinical Neurophysiology and Epilepsies, St Thomas’ Hospital, Lambeth Palace Road, London SE1 7EH, UK.
Self induced seizures are commonly encountered in photosensitive epileptic patients.1 Pattern,1musicogenic, and cheirogenic2 self induced seizures are rarely described. In all cases the manoeuvres employed by the patients implicate external stimuli. Self induced seizures with internal stimuli have not been reported.
In noogenic or thinking epilepsy seizures are precipitated by elaborate mental activity implicating decision complexity, sequential factors, and possibly related stress. In this condition a third of the patients also show photoparoxysmal discharges but not clinical photosensitivity.3
We report a photosensitive patient who induced absences by a specific noogenic process of predominant emotional character.
A 20 year old man of normal intelligence had a family history of seizures and a febrile convulsion at the age of 4. At the age of 11 he had generalised tonic-clonic seizures on three occasions while watching television. At that stage EEG showed frequent spontaneous generalised 3–4 Hz polyspike and wave discharges of up to five seconds and pronounced photosensitivity to frequencies from 10 to 50 Hz. Physical means for seizure prevention such as dispersion screens fitted on the TV screen, polaroid glasses, and monocular viewing had limited success. One year later, treatment with sodium valproate was initiated because of additional spontaneous clusters of absence seizures often …
