Friday, January 25, 2019

Blog #102: Reflex Epilepsies

            Last month’s blog, PHOTOSENSITIVE EPILEPSY (# 101), posted December 26, 2018 on LANCEFOGAN.COM, introduced the reflex epilepsies. This reflex epilepsy is seizures initiated by exposure to flashing and flickering lights. Other reflex epilepsies are seizures that develop in response to a specific motor, sensory or cognitive stimulus. Most are uncommon, some are rare. 

  •             In susceptible people, certain thoughts―the cognitive stimulus—can trigger a seizure. An example can be sequential decision-making. Reflex seizures may be generalized, or focal, and they can be associated with, or without, impaired consciousness. If consciousness is impaired it’s a ‘complex’ focal seizure. If consciousness remains intact during the seizure it is a ‘simple’ focal seizures. Reflex epilepsy can be caused by: 1) a genetic trait and some specific genes are known; if a causative gene hasn’t been recognized, it’s idiopathic reflex epilepsy, i.e., of unknown cause; or 2) symptomatic reflex seizures which are due to a structural brain abnormality such as tumor, stroke, infection, or traumatic scar. Photosensitive epilepsy is the most genetic, i.e. hereditary. The other reflex epilepsies’ causative genes are elusive and run less in families.


  •             Eating epilepsy is very rare. It occurs in fewer than one person in 1000 people with epilepsy. It is not associated with particular foods, rather, the seizure seems to come on during the act of swallowing. Additionally, some people develop seizures if they visualized, smelled or even thought of, a particular food.
  •             Musicogenic-evoked epilepsy can be associated with certain music themes or music notes. The seizures can be even be precipitated by singing voices. It was found that some singers' voices, but not other singers’ voices, were particularly epileptogenic in the sensitive person afflicted. Additionally, some songs, but not others, would precipitate a seizure in these sensitive individuals.
  •             Movement-induced epilepsy starts with certain movements in that person.
  •             Auditory-evoked epilepsy is when a seizure is evoked with startling sounds.
 
 
           We await research to reveal more about how stimuli such as these above can induce seizures.

 



Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is his first novel. It is a mother’s dramatic story that teaches epilepsy, now available in eBook, audiobook and soft cover editions.