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Reflex seizures induced by eating are thought to be rare except in specific regions of Sri Lanka and India. They are predominantly of complex or simple partial type and are invariably associated with a symptomatic localisation-related epilepsy.1
Here, we report a patient presenting with unusual prandial-reflex-type ictal phenomenology and infratentorial, macrocystic lesion occupying the lower dorsal half of the medulla oblongata, anatomically co-localising with the dorsal vagal nucleus (DVN) and the nucleus tractus solitarius (NTS), diagnosed as haemangioblastoma on MRI.
A retired 67-year-old ex-lorry-driver presented with stereotyped attacks during meals. They were characterised by an odd metallic taste and a strange non-specific feeling after the first or second bite of the meal, without impairment of consciousness. After 2 years, these evolved into more serious attacks in which he would cough for about 30 seconds and then vomit. Following this, he was amnesic and confused for up to 30 minutes. During this phase, he was able to talk but mainly repeated simple questions and there were no other physical manifestations. The attacks appeared infrequently, up to …