Abstracts

Rationale: Eye closure sensitivity is a transient brief change in the electroencephalogram (EEG) baseline immediately after eye closure, mainly described as epileptiform in appearance. This has been more commonly reported in the literature with photosensitive childhood epilepsies. A case series of 26 adult patients was reported in 2007 with the diagnoses of eyelid myoclonia with absence, idiopathic generalized epilepsy, juvenile myoclonic epilepsy, and occipital lobe epilepsy. In this case, the patient is suspected to have temporal lobe epilepsy. This case is remarkable because there are currently no reported cases of eye closure sensitivity in adult patients with temporal lobe epilepsy. Methods: This is a case report of a patient with eye closure sensitivity and suspected temporal lobe epilepsy. Results: M.V. is a 34 year old right handed female that began having seizures 13 years prior to presentation. She described the seizures as starting with hearing a particular song, followed by jaw tightening and right facial twitching. She would then lose consciousness and let out a high pitch noise with full body rigidity and sometimes jerking of the bilateral upper extremities. She continued to have seizures despite lamotrigine monotherapy. She was tapered off of lamotrigine and noted a drastic increase in events. Her interictal EEG showed intermittent right temporal theta slowing. The recording also showed eye closure sensitivity with transient semirhythimcal sharply contoured delta and theta frequencies following eye closure lasting 1.5-3 seconds. She was started on oxcarbazepine and had no further tonic clonic seizures. Conclusions: The patient's clinical presentation seems most consistent with focal onset epilepsy, likely localizing to the temporal lobe. Eye closure sensitivity is a phenomenon that has been reported mostly in children with limited literature for adult patients. There are no previous reports of an adult with this EEG finding and temporal lobe epilepsy which makes this case unique. Continued research into this phenomenon is important and may provide important clues when interpreting EEGs.